Development and Internal Validation of a Novel Nomogram to Predict the Risk of Postoperative Acute Kidney Injury Following Robot-Assisted Partial Nephrectomy.

Objectives: To develop a predictive tool to assist in predicting the risk of Acute Kidney Injury (AKI) following robot-assisted partial nephrectomy (RAPN).

Methods: A retrospective review was performed on the prospectively maintained, IRB-approved database to identify all consecutive patients who underwent RAPN between 2008 and 2023. Patients with end-stage kidney disease (ESKD), horseshoe kidneys, solitary kidneys, and previous renal transplant recipients were excluded.

Acidic Microenvironment Enhances Cisplatin Resistance in Bladder Cancer via Bcl-2 and XIAP.

Cisplatin (CDDP) remains a key drug for patients with advanced bladder cancer (BC), despite the emergence of new therapeutic agents; thus, the identification of factors contributing to CDDP treatment resistance is crucial. As acidity of the tumor microenvironment has been reported to be associated with treatment resistance and poor prognosis across various cancer types, our objectives in this study were to investigate the effects of an acidic environment on BC cells and elucidate the mechanisms behind CDDP resistance. Our findings show that BC cells cultured under acidic conditions developed cisplatin resistance as acidity increased.

Exploring the utility of snRNA-seq in profiling human bladder tissue: A comprehensive comparison with scRNA-seq.

Single cell sequencing technologies have revolutionized our understanding of biology by mapping cell diversity and gene expression in healthy and diseased tissues. While single-cell RNA sequencing (scRNA-seq) has been widely used, interest in single-nucleus RNA sequencing (snRNA-seq) is growing due to its benefits, including the ability to analyze archival tissues and capture rare cell types that are challenging to dissociate. However, comparative studies across tissues have yielded mixed results, with some reporting enhanced cell type retention using snRNA-seq while others finding cell type identification to be challenging in snRNA-seq data.

Reducing Quotation Errors in Scientific Manuscripts: A Novel Approach from the Global Andrology Forum.

Purpose: This study investigated 1) the frequency of quotation errors in multi-authored medical manuscripts in andrology, 2) analyzed common types of quotation errors and the methods used to rectify them, and 3) evaluated their impact on manuscript accuracy, credibility, and research conclusions.

Materials And Methods: Twelve manuscripts written by the Global Andrology Forum (GAF) members between 2023 and 2024 were randomly selected for this study. The manuscripts and "Quotation Verification Sheets" were analyzed by senior GAF researchers to detect the number and types of quotation errors.

Overview of three decades of management patterns of renal angiomyolipomas.

Objective: To analyze clinical and radiological features and trends in the management pattern of renal angiomyolipomas (AML) in a tertiary care center over a 30-year period.

Patients And Methods: We retrospectively reviewed the charts of patients referred to our institutions from 1992 to 2022 with final diagnosis of AML. Demographics, clinical presentation, radiological findings, renal function status, and treatment options were recorded.

Benign Prostatic Hyperplasia Knowledge Deficits Among Male Urology Patients.

Objective: To measure patient knowledge about Benign prostatic hyperplasia (BPH) and identify factors associated with knowledge deficiencies among those newly presenting to our urology clinic.

Methods: Adult men presenting as new patients to our institution's urology clinic regardless of chief complaint were invited to complete a 26-item multiple choice questionnaire to assess basic knowledge about BPH, related symptomatology, and treatment options prior to their initial consultation. Responses were correlated to demographic variables using ANOVA and multivariable linear modeling.

Low baseline IsoPSA Index is associated with a Prolonged Low Risk of Clinically Significant Prostate Cancer Diagnosis in Men with an Elevated PSA.

Objective: To compare the rate of diagnosing clinically significant prostate cancer (csPCa) in men with elevated PSA stratified by baseline IsoPSA Index, thus assessing IsoPSA's intermediate-term predictive ability for csPCa.

Material And Methods: Single-center retrospective review of consecutive patients (n=1578) who underwent IsoPSA testing from November 2016-August 2022. Data dichotomized into patients with low(≤6) and high IsoPSA Indices (>6).

Precision Medicine Proof-of-Concept Study of a TNF Inhibitor in FSGS and Treatment-Resistant Minimal Change Disease.

Background: Focal segmental glomerulosclerosis (FSGS) and treatment-resistant minimal change disease (TR-MCD) are heterogeneous disorders with subgroups defined by distinct underlying mechanisms of glomerular and tubulointerstitial injury. A non-invasive urinary biomarker profile has been generated to identify patients with intra-kidney tumor necrosis factor (TNF)-activation and to predict response to anti-TNF treatment. We conducted this proof-of-concept, multi-center, open-label clinical trial to test the hypothesis that in patients with FSGS or TR-MCD and evidence of intra-renal TNF activation based on their biomarker profile, short-term treatment with adalimumab would reverse the elevated urinary excretion of MCP-1 and TIMP-1.

Vascular Access for Home Hemodialysis: A Perspective on Tunneled Central Venous Catheters at Home.

Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.

Routine Sperm Cryopreservation Before Vasectomy Is not Cost-effective and Does not Increase Live Birth Rates Compared to Surgical Sperm Retrieval or Vasectomy Reversal.

Objective: To determine if routine pre-vasectomy sperm cryopreservation is more cost-effective than fertility restoration for patients who desire additional children following vasectomy?

Methods: A scoping review was performed to collect published data regarding efficacy and outcomes of cryopreservation, vasectomy reversal, surgical sperm retrieval, and assisted reproductive technologies (ART). Cost data were collected from US-based facilities performing cryopreservation and andrology clinical care. A cost-effectiveness model was generated using TreeAge Pro cost-effectiveness modeling software with 3 different variations representing a balanced scenario with median expected parameter values, a scenario with assumptions/variables favoring pre-vasectomy cryopreservation, and a scenario favoring fertility restoration.

The influence of seminal microbiota on human testicular steroidogenesis: a prospective study.

Objective: Preclinical evidence has demonstrated that gut microbiota composition can influence steroid hormone biosynthesis and spermatogenesis. This study aims to investigate the association of seminal microbiota and testicular steroidogenesis.

Patients And Methods: One hundred adult eugonadal men were consecutively enrolled.

Implementation of a Comprehensive Protocol for Enhanced Recovery After Surgery (ERAS) in Kidney Transplant Recipients Improves Patient and Graft Outcomes.

Background: Enhanced recovery after surgery (ERAS) protocols have gained widespread acceptance as a means to enhance surgical outcomes. However, the intricate care required for kidney transplant recipients has not yet led to the establishment of a universally recognized and dependable ERAS protocol for kidney transplantation.

Objective: We devised a customized ERAS protocol to determine its effectiveness in improving surgical and postoperative outcomes among kidney transplant recipients.

Urothelial carcinoma in situ with "early papillary formation" vs "lateral spread/shoulder lesion" of prior high-grade noninvasive papillary urothelial carcinoma: A survey of pathologist and urologist interpretations.

Objectives: Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.

Methods: It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.

Results: Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as "CIS with early papillary features" (38% for groups 1 and 2 vs 13% for group 3).

Role of gliflozins on hepatocellular carcinoma progression: a systematic synthesis of preclinical and clinical evidence.

Introduction: The risk of HCC is twice as high in diabetic patients compared to non-diabetic ones, suggesting that diabetes advances carcinogenesis in the liver through a variety of mechanisms. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve liver outcomes, emerging as promising agents to treat hepatocellular carcinoma (HCC) in patients with type 2 diabetes mellitus (T2DM).

Methods: We searched PubMed and Scopus databases for articles presenting an association between SGLT2is and HCC to explore the putative mechanisms of action underlying the anti-proliferative activity of SGLT2is.

Diuretic management protocol to improve quality and safety in managing acute heart failure in an integrated health system: An implementation science approach.

Background: Effective and timely decongestion in acute heart failure (AHF) coupled with careful discharge planning is critical in the successful treatment of patients hospitalized for AHF. We leveraged an implementation science framework to develop a health system-wide diuretic management protocol (DMP) based on emerging clinical evidence.

Methods: We conducted stakeholder interviews using the Integrated Promoting Action on Research Implementation in Health Services (iPARiHS) Framework.

Mechanism of Nephrolithiasis: Does the Microbiome Play a Role?

Nephrolithiasis imposes a significant health care burden around the world. In the past decade, there has been considerable interest in the human microbiota in relation to the onset of nephrolithiasis. Most of the research has focused on degradation of oxalate, a known causative factor for nephrolithiasis, by bacteria in the gut.

Novel bioabsorbable, low-dose rate brachytherapy device (CivaSheet) with radical prostatectomy and adjuvant external beam radiation for the management of prostate cancer.

Objective: To investigate the safety and cancer control of a novel bioabsorbable, low-dose rate brachytherapy device, CivaSheet (CivaTech Oncology Inc., Durham, NC, USA), in combination with radical prostatectomy (RP) with or without adjuvant external beam radiation therapy (EBRT) for the management of prostate cancer (PCa).

Patients And Methods: This is an initial, single-centre experience, two-dose level, two-stage study conducted on patients with intermediate- and high-risk PCa.

Sarcopenia may increase cisplatin toxicity in bladder cancer patients with borderline renal function.

Objectives: To assess whether the effect of sarcopenia on neoadjuvant chemotherapy (NAC) toxicity is modified by borderline renal function (estimated glomerular filtration rate [eGFR] 40-65 mL/min) and whether sarcopenia and borderline renal function are independently associated with NAC toxicity risk.

Patients And Methods: All patients with muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy (RC) between 2010 and 2022, with available cross-sectional imaging prior to NAC initiation, were included. Skeletal mass was measured from axial computed tomography images obtained at the level of the L3 vertebral body, using Aquarius Intuition software.

Pure open versus robotic radical cystectomy with intracorporeal urinary diversion: a propensity matched analysis.

Objective: To compare surgical parameters and short-term outcomes between open radical cystectomy (ORC) and robotic radical cystectomy with total intracorporeal urinary diversion (icRARC).

Methods: Among the study period, 133 patients who underwent ORC and pelvic node dissection for bladder cancer (group 1) were matched and compared to 61 patients who underwent icRARC during the same period (group 2). The groups were matched 1:1 according to their propensity scores adjusted on their baseline demographics and disease characteristics.