Ophthalmologic toxicities of antineoplastic agents in genitourinary cancers: Mechanisms, management, and clinical implications.

Genitourinary cancers affect over 480,000 patients in the United States annually. While promising therapeutic modalities continue to emerge, notably immune checkpoint inhibitors, molecular targeted therapies, antibody-drug conjugates, and radioligand therapies, these treatments are associated with a spectrum of adverse side-effects, including ophthalmologic toxicities. In this review, we cover the most commonly used antineoplastic agents for the kidneys, bladder, urinary tracts, prostate, testis, and penis, detailing mechanism, indication, and recent trials supporting their use.

Increasing Life Expectancy in Patients with Genitourinary Malignancies: Impact of Treatment Burden on Disease Management and Quality of Life.

Background And Objective: Treatment burden refers to the overall impact of medical treatments on a patient's well-being and daily life. Our objective is to evaluate the impact of treatment burden on quality of life (QoL) in patients with genitourinary (GU) malignancies, highlighting the importance of patient-reported outcomes (PROs) in clinical trials to inform treatment decisions and improve patient care.

Methods: We conducted a narrative review of clinical trials focused on GU malignancy (prostate, bladder, and kidney) between January 2000 and June 2024, analyzing related PROs and findings regarding treatment burden.

Aldehyde free - Bovine Pericardium - A New Option of Graft in Urethral Stricture Treatment.

Objective: The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures (injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, bladder mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material) (1, 2).

Vitamin D binding protein genetic isoforms, serum vitamin D, and cancer risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

Associations between vitamin D biochemical status and cancer may be modified by vitamin D binding protein isoforms which are encoded by GC (group-specific component). We examined interactions between serum 25-hydroxyvitamin D [25(OH)D], the Gc isoforms Gc1-1, Gc1-2, and Gc2-2, and cancer risk within the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial cohort based on 3,795 cases and 3,856 controls. Multivariable-adjusted logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of cancer risk according to 25(OH)D quantiles, stratified by Gc isoform.

A novel smartphone application for bladder cancer management (BCM App): Design, development, and usability evaluation.

Background: Providing clinical guidelines to clinicians using innovative technologies seems practical and useful. This study aimed to design, develop, and evaluate a smartphone application to assist urologists in managing bladder cancer (BCM App).

Materials And Methods: The study was conducted in three phases, following the user-centered design model, at the urology clinic of Khorshid Hospital (Isfahan, Iran) in 2021.

The acute phase management of traumatic spinal cord injury (tSCI) with polytrauma: A narrative review.

Introduction: Traumatic spinal cord injury (tSCI) is frequently observed in polytrauma patients.

Research Question: What is the optimal strategy to manage tSCI in the setting of polytrauma?

Material And Methods: This narrative review focuses on: 1) extraspinal damage control surgery and resuscitation, 2) the perioperative protection of the injured spine during emergency surgery, 3) imaging and timing of spinal surgery in polytrauma, 4) early interventions for skin, bowel and bladder, and 5) the multidisciplinary approach to tSCI polytrauma patients.

Results: Damage control resuscitation (DCR) and damage control surgery (DCS), aim to prevent/correct post-traumatic physiological derangements to minimize bleeding until definitive hemostasis is achieved.

Reversal of Endometriosis-Induced Unilateral Ureteral Obstruction and Hydronephrosis With Medical Therapy.

Endometriosis is a common condition among women of reproductive age worldwide, with the urinary tract being the second most frequently affected extragenital organ system, particularly the bladder and ureters. Ureteral endometriosis (UE) is relatively rare, often asymptomatic, and can lead to progressive renal function loss if not addressed promptly. Early diagnosis and intervention are essential, requiring a high index of suspicion.

Anorectal manometry and urodynamics in children with spina bifida: can we predict the colonic dysmotility from bladder dysfunction?

Introduction: Spina bifida is a condition that impacts the development of the neural tube leading to urological and gastrointestinal symptoms. Both systems are influenced together due to their shared innervation and embryological origin. Despite its impact on health and well-being there has been limited research on the relationship between manometry results and urodynamic tests, in this patient population.

Utilizing the Ellik bladder evacuator during cystoscopic retrieval of urocystoliths in 12 dogs.

Background: Urocystolithiasis is a common problem in dogs; many canine uroliths are resistant to medical dissolution. Novel management options would expand, and in some cases improve, current urolith retrieval strategies.

Hypothesis/objectives: To describe a previously unreported technique by the Ellik bladder evacuator (EE) to assist in minimally invasive, cystoscopic retrieval of canine cystoliths.

Bladder sparing management for muscle-invasive bladder cancer after a complete clinical response: ready for prime time?-a narrative review.

Background And Objective: A standard of care for muscle-invasive bladder cancer (MIBC) is cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC). Given recent improvements in NAC and the morbidity associated with RC, bladder-sparing therapy has been investigated as a promising treatment for patients with MIBC who experience a complete clinical response (CCR) to systemic therapy. However, clinical staging is unreliable, making it challenging to determine ideal candidates for bladder-sparing therapy.

Loss of MK2 Enhances Radiation-Mediated Apoptosis in Bladder Cancer.

Background: Bladder cancer patients unable to receive cystectomy or who choose to pursue organ-sparing approach are managed with definitive (chemo)radiotherapy. However, this standard of care has not evolved in decades and disease recurrence and survival outcomes remain poor. Identifying novel therapies to combine with radiotherapy (RT) is therefore paramount to improve overall patient outcomes and survival.

Impact of immigration background on feasibility of electronic patient-reported outcomes in advanced urothelial cancer patients.

Background: Electronic patient-reported outcomes (ePROs) have been shown to enhance healthcare quality by improving patient symptom management or quality of life (QoL). However, ePROs data for urothelial cancer (UC) patients receiving systemic therapies are scarce, and the application of ePROs in this patient cohort may need specific setups. This study tested the feasibility of ePROs for UC patients receiving systemic therapies in the outpatient clinic of a tertiary care center.

Indications and Outcomes of Fetal Cystoscopy for Lower Urinary Tract Obstruction: A Comprehensive Review.

Fetal lower urinary tract obstruction (LUTO) encompasses a spectrum of rare congenital anomalies affecting the fetal urinary system, leading to significant morbidity and mortality. This condition, arising from various anatomical anomalies such as posterior urethral valves (PUV), urethral atresia, and cloacal malformations, disrupts normal urine flow, resulting in secondary complications such as pulmonary hypoplasia and renal impairment. Current management strategies, including fetal vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to alleviate obstruction and mitigate associated risks.

Female Pelvic Conditions: Interstitial Cystitis/Bladder Pain Syndrome.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a likely underdiagnosed chronic pain syndrome consisting of pelvic pain lasting longer than 6 weeks plus lower urinary tract symptoms in the absence of infection or other identifiable cause. It is more common after 40 years of age. The etiology is unclear, but some patients have inflammatory findings in the bladder known as Hunner lesions.

Wilms' Tumor - An Audit.

Background And Aims: Outcome analysis of patients with Wilms' tumors (WT) is presented.

Materials And Methods: A retrospective analysis of 23 children having WT managed by a single surgeon over 3 years (2021-2024) using the International Society of Paediatric Oncology Umbrella protocol was done.

Results: The median age at presentation was 36 months; 32 months and 24 months for the unilateral WT (uWT) ( = 19) and bilateral WT (bWT) ( = 4), respectively.

Cost-effectiveness of nivolumab combined with chemotherapy as a first-line therapy for patients with unresectable or metastatic urothelial carcinoma.

Background: Urothelial carcinoma is a significant health concern in the United States (US), with high mortality and economic burdens. The CheckMate-901 trial showed promising survival benefits for nivolumab combined with gemcitabine and cisplatin followed by nivolumab maintenance therapy (nivolumab-combination) as first-line treatment of unresectable or metastatic urothelial carcinoma (UC), but its cost-effectiveness is unclear.

Objectives: This study aimed to evaluate the cost-effectiveness of the nivolumab-combination versus standard chemotherapy (gemcitabine-cisplatin) for advanced UC from the perspective of healthcare payers in the US.

Long-Term Decision Regret and Associated Factors Following Urinary Reconstruction in Underserved Patients with Spinal Cord Injury.

Purpose: Patients with refractory neurogenic bladder dysfunction may require urinary reconstruction due to severe incontinence, difficulty with catheterization, and to prevent upper urinary tract compromise. We evaluated long-term decisional regret and associated factors following urinary reconstruction in spinal cord injury patients.

Materials And Methods: We interviewed patients with spinal cord injuries who underwent bladder reconstruction surgery at least ten years ago, administering validated surveys on bowel quality of life and dysfunction, urinary tract infections, and decisional regret.

Hand Grip Strength Index, a Novel Tool in Risk-Assessing Multi-Ethnic End-Stage Kidney Disease Patients Treated by Haemodialysis.

Introduction: Increasing numbers of elderly co-morbid patients with end-stage kidney disease (ESKD) are now offered haemodialysis. Simple, rapid screening tools are required to risk-assess patients, highlighting those requiring nutritional or other support and advising on prognosis. As such, we assessed a newly introduced tool, the hand grip strength index (HGS index), a comparison of measured to predicted HGS.

A case of lead migration after sacral neuromodulation with erosion into the rectum.

We present a case of a 73-year-old female with medication refractory overactive bladder treated with the InterStim® sacral neuromodulation device. Five months post implantation she developed drainage over the lead site and rectal bleeding. Evaluation identified lead migration with rectal perforation requiring surgical removal of the battery and lead.

Cascade-Activatable Nanoprodrug System Augments Sonochemotherapy of Bladder Cancer.

Sonochemotherapy (SCT) has emerged as a powerful modality for cancer treatment by triggering excessive production of reactive oxygen species (ROS) and controlled release of chemotherapeutic agents under ultrasound. However, achieving spatiotemporally controlled release of chemotherapeutic agents during ROS generation is still an enormous challenge. In this work, we developed a cascade-activated nanoprodrug () system that utilizes a reversible covalent Schiff base mixed with a hypoxia-activatable camptothecin (CPT) prodrug.

Does Muscle Pain Induce Alterations in the Pelvic Floor Motor Unit Activity Properties in Interstitial Cystitis/Bladder Pain Syndrome? A High-Density sEMG-Based Study.

Several studies have shown interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic condition that poses challenges in both diagnosis and treatment, is associated with painful pelvic floor muscles (PFM) and altered neural drive to these muscles. However, its pathophysiology could also involve other alterations in the electrical activity of PFM motor units (MUs). Studying these alterations could provide novel insights into IC/BPS and help its clinical management.

Bladder Outlet Obstruction Due to Recurrent Complete Labial Fusion in Postmenopausal Woman-Case Report.

Background: Labial fusion is a rare condition typically observed in prepubescent girls, but it can also occur in postmenopausal women due to estrogen deficiency.

Methods: Our case report presents a unique instance of recurrent complete labial fusion causing bladder outlet obstruction in a postmenopausal woman.

Results: The 84-year-old patient presented with dysuria and intermittent urine leakage.

Sex Disparities in Bladder Cancer Diagnosis and Treatment.

Gender differences in prevalence, tumor invasiveness, response to treatment, and clinical outcomes exist in different types of cancer. The aim of this article is to summarize the sex disparities in bladder cancer diagnosis and treatment and try to suggest areas for improvement. Although men are at a higher risk of developing bladder tumors, women tend to be diagnosed with more advanced stages at diagnosis and are more likely to present with upfront muscle-invasive disease.

High-power versus low-power laser settings during endoscopic stone disease management: a systematic review from the EAU endourology section.

Purpose: Optimal laser settings during endoscopic stone disease management still represents a debatable issue. The aim of this systematic review is to summarize all existing evidence regarding the comparison of high-power (HP) versus low-power (LP) laser settings during different endoscopic lithotripsy procedures.

Methods: PubMed, Scopus and Cochrane databases were systematically screened, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines.

The Efficacy of Micro-Radiofrequency Therapy for Treating Non-Hunner Lesion Interstitial Cystitis/Bladder Pain Syndrome: A Retrospective Cohort Study.

Introduction And Hypothesis: The objective was to explore the efficacy of micro-radiofrequency (micro-RF) therapy for treating non-Hunner interstitial cystitis (NHIC).

Methods: Forty female NHIC patients were enrolled in this retrospective study from December 2021 to December 2023, with 20 receiving intravesical micro-RF therapy and 20 undergoing hydrodistension (HD). The primary evaluation index was the treatment success rate using the Global Response Assessment (GRA) scale.