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Gamma‐butyrobetaine dioxygenase (BBOX1) is a catalyst for the conversion of gamma‐butyrobetaine to l‐carnitine, which is detected in normal renal tubules. The purpose of this study was to analyze the prognosis, immune response, and genetic alterations associated with low BBOX1 expression in patients with clear cell renal cell carcinoma (RCC). We analyzed the relative influence of BBOX1 on survival using machine learning and investigated drugs that can inhibit renal cancer cells with low BBOX1 expression. We analyzed clinicopathologic factors, survival rates, immune profiles, and gene sets according to BBOX1 expression in a total of 857 patients with kidney cancer from the Hanyang University Hospital cohort (247 cases) and The Cancer Genome Atlas (610 cases). We employed immunohistochemical staining, gene set enrichment analysis, in silico cytometry, pathway network analyses, in vitro drug screening, and gradient boosting machines. BBOX1 expression in RCC was decreased compared with that in normal tissues. Low BBOX1 expression was associated with poor prognosis, decreased CD8+ T cells, and increased neutrophils. In gene set enrichment analyses, low BBOX1 expression was related to gene sets with oncogenic activity and a weak immune response. In pathway network analysis, BBOX1 was linked to regulation of various T cells and programmed death‐ligand 1. In vitro drug screening showed that midostaurin, BAY‐61‐3606, GSK690693, and linifanib inhibited the growth of RCC cells with low BBOX1 expression. Low BBOX1 expression in patients with RCC is related to short survival time and reduced CD8+ T cells; midostaurin, among other drugs, may have enhanced therapeutic effects in this context. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of poloxamer‐based thermo‐sensitive sol–gel instillation, after transurethral resection of the prostate (TURP), for preventing urethral stricture. Patients and Methods: In all, 198 patients underwent TURP for benign prostatic hyperplasia. Recruited patients were randomly divided into two groups: groups A and B. Patients in Group A (100 patients, experimental group) received poloxamer‐based thermo‐sensitive sol–gel instillation and patients in the Group B (98 patients, control group) received lubricant instillation after TURP. Each patient was evaluated at 4 (V1), 12 (V2), and 24 weeks (V3) after TURP. The effectiveness of poloxamer‐based thermo‐sensitive sol–gel instillation was evaluated based on the International Prostate Symptom Score (IPSS), IPSS‐Quality of Life (QoL), Overactive bladder questionnaire (OAB‐q), maximum urinary flow rate (Qmax), post‐void residual urine volume (PVR), and cystoscopy. Results: Amongst the initial 198 participants, 80 patients in Group A and 83 in Group B completed the study. There were no significant differences in IPSS‐QoL and OAB‐q between the groups. However, Qmax was significantly different between groups A and B, at a mean (SD) of 18.92 (9.98) vs 15.58 (9.24) mL/s (P = 0.028) at 24 weeks after TURP. On cystoscopic examination, urethral stricture after TURP was found in two of the 80 patients in Group A and 10 of 83 in Group B (P = 0.023). Conclusions: Poloxamer‐based thermo‐sensitive sol–gel instillation after TURP lowered the incidence of urethral stricture. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness and safety of instilling highly concentrated hyaluronic acid (HA)/chondroitin sulphate (CS) on ureteric stent‐related pain, urinary symptoms, and quality of life (QoL) of patients who underwent ureteroscopic lithotripsy for ureteric stones followed by ureteric stent placement. Patients and Methods: Eligible patients were randomly allocated to receive intravesical instillation with HA/CS or normal saline just after ureteric stent placement. Just before stent removal on postoperative day 7, the patients completed the Ureteric Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS) QoL question, and a pain visual analogue scale (VAS). Results: In total, 92 patients (46 each in the treatment and control arms) completed the study. The groups did not differ in terms of age or stent indwelling time. Compared with the control group, the treatment group had significantly lower USSQ urinary symptom domain scores (24.6 vs 32.5; P < 0.001), better IPSS QoL scores (3.5 vs 4.4, P = 0.018), and lower VAS pain scores (2.0 vs 3.2; P < 0.001). They also had lower total body pain subscores (16.7 vs 22.0; P = 0.01) and lower additional pain subscores due to urinary tract infections (2.1 vs. 3.2; P = 0.01) in the USSQ. Conclusions: Highly concentrated HA/CS effectively improved urinary symptoms and pain, and reduced the need for additional medication or procedures after ureteric stent placement. [ABSTRACT FROM AUTHOR]

Objectives We aimed to examine the treatment patterns, and patient-reported outcomes ( PROs) in benign prostatic hyperplasia ( BPH) patients with overactive bladder ( OAB) symptoms. Methods Seven hundred and forty seven patients were included in this prospective observational study. The primary endpoint was to describe the medical treatment patterns for BPH patients with OAB symptoms. The secondary endpoint was to determine the PROs of these patients. Clinical outcome was assessed using International prostate symptom score ( IPSS), and PROs were measured using BPH-Related QoL Questionnaire Korea 1 ( BPH QoL K1) and Euroqol-5 Dimension ( EQ-5D). Results When starting the study, 391 patients (52.3%) received α-blocker monotherapy, whereas 356 (47.7%) received combination therapy with anticholinergics. Of the 369 patients who completed the 6-month treatment, 139 patients (37.7%) still received α-blocker monotherapy, 122 (33.1%) still received combination therapy with anticholinergics, and 108 (29.3%) received subsequent anticholinergics in addition to α-blocker. When the patients were stratified, storage subscore was higher (9.5 vs. 8.8, P = 0.034) and voiding subscore (9.7 vs. 11.6, P = 0.001) was lower in patients with anticholinergics than those without it. Although all treatment groups reported a significant improvement from baseline, no significant between-group differences in changes in IPSS, EQ-5D and BPH QoL K1 was found. Conclusions About one-third of patients received α-blocker monotherapy, one-third received combination therapy with anticholinergics, and another one-third received subsequent anticholinergics in addition to α-blocker. Storage subscore was higher in patients with anticholinergics than those without it, but vice-versa for voiding subscore. Similar improvement on clinical outcomes and PROs was observed in all treatment groups. [ABSTRACT FROM AUTHOR]

Objectives Randomized controlled trials are one of the most reliable resources for assessing the effectiveness and safety of medical treatments. Low quality randomized controlled trials carry a large bias that can ultimately impair the reliability of their conclusions. The present study aimed to evaluate the quality of randomized controlled trials published in International Journal of Urology by using multiple quality assessment tools. Methods Randomized controlled trials articles published in International Journal of Urology were found using the Pub Med MEDLINE database, and qualitative analysis was carried out with three distinct assessment tools: the Jadad scale, the van Tulder scale and the Cochrane Collaboration Risk of Bias Tool. The quality of randomized controlled trials was analyzed by publication year, type of subjects, intervention, presence of funding and whether an institutional review board reviewed the study. Results A total of 68 randomized controlled trial articles were published among a total of 1399 original articles in International Journal of Urology. Among these randomized controlled trials, 10 (2.70%) were from 1994 to 1999, 23 (4.10%) were from 2000 to 2005 and 35 (4.00%) were from 2006 to 2011 ( P = 0.494). On the assessment with the Jadad and van Tulder scale, the numbers and percentage of high quality randomized controlled trials increased over time. The studies that had institutional review board reviews, funding resources or that were carried out in multiple institutions had an increased percentage of high quality articles. Conclusions The numbers and percentage of high-quality randomized controlled trials published in International Journal of Urology have increased over time. Furthermore, randomized controlled trials with funding resources, institutional review board reviews or carried out in multiple institutions have been found to be of higher quality compared with others not presenting these features. [ABSTRACT FROM AUTHOR]

What's known on the subject? and What does the study add? LESS-NU may be an alternative minimally-invasive treatment option for patients eligible to undergo laparoscopic surgery for upper urinary tract urothelial carcinoma., The true benefits of LESS-NU remain to be determined and require randomized control trials in the future. Despite encouraging early findings, clinical trials still are warranted before this procedure is adopted widely, and longer follow-up is needed to determine its oncological durability., Objective To report a large multi-institutional series of laparoendoscopic single-site ( LESS) nephroureterectomy ( NU)., Materials and Methods Data on all cases of LESS-NU performed between 2008 and 2012 at 15 institutions were retrospectively gathered., The main demographic data and perioperative outcomes were analysed., Results The study included 101 patients whose mean ( sd) age was 66.4 (9.9) years and mean ( sd) body mass index was 24.8 (4) kg/m2, and of whom 29.7% had undergone previous abdominal/pelvic surgery., The mean ( sd) operating time was 221.4 (73.7) min, estimated blood loss 231.7 (348.0) mL., A robot-assisted LESS technique was applied in 25.7% of cases. An extra trocar was inserted in 28.7% of cases to complete the procedure. Conversion to open surgery was necessary in three cases (3.0%). There was no bladder cuff excision in 20.8% of cases, and excision was carried out using a variety of techniques in the remaining cases., Six intra-operative complications occurred (5.9%). The mean ( sd) length of hospital stay was 6.3 (3.5) days. The overall postoperative complication rate was 10.0%, and most of the complications were low grade ( Clavien grades 1 and 2)., The mean tumour size was 3.1 (1.9) cm. Pathological staging was pTis in two patients, pTa in 12 patients, pT1 in 42 patients, pT2 in 20 patients, pT3 in 23 patients and pT4 in two patients. Pathological grade was high in 71 and low in 30 patients., At a mean follow-up of 14 months, six patients (5.9%) had died. Disease recurrence (including distant and bladder recurrence) was detected in 22.8% of patients, with a mean time to recurrence of 11.5 months., Conclusions This study reports the largest multi-institutional experience of LESS-NU to date., Peri-operative outcomes mirror those of published standard laparoscopy series., Despite encouraging early findings, longer follow-up is needed to determine the oncological efficacy of the procedure. [ABSTRACT FROM AUTHOR]

Aims Fibromyalgia syndrome (FMS) is the most common disease causing chronic generalized pain, and FMS patients often complain of urinary symptoms such as frequency or urgency. This study focuses on the association of overactive bladder (OAB) and FMS in adults aged 40 and over. Methods A survey of adults aged 40s and over was conducted in the Guri and Yangpyeong areas of South Korea. The response rate was 74.2% (940/1,266). After excluding subjects with incomplete questionnaires (n = 20), 920 were included in the final analysis. The association of FMS and OAB was analyzed by univariate and multivariate logistic regression analysis. Results Individuals with FMS had a significantly increased symptoms of OAB after adjustment for gender, age group, and area of residence (odds ratio (OR) 3.39, 95% confidence interval (CI) 1.82-6.31). The association between FMS and severity of OAB was statistical significant ( P for trend <0.0001). Conclusions OAB is associated with FMS. Moreover FMS increases with severity of OAB. Neurourol. Urodynam. 32: 66-69, 2013. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Aims To evaluate the efficacy and safety of solifenacin 5 mg to treat voiding symptoms caused by idiopathic normal pressure hydrocephalus (iNPH) after a ventriculoperitoneal (V-P) shunt operation. Methods A total of 53 patients diagnosed with iNPH and complaining of voiding symptoms were enrolled. Before treatment with solifenacin (V1), 4 (V2) and 12 (V3) weeks after starting solifenacin overactive bladder symptom score (OABSS), the International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximal urine flow rate (Qmax), voided volume, and post-voiding residual urine volume (PVR) were measured. An urodynamic study (UDS) was performed at V1 and V3, and the safety of solifenacin was assessed at V1, V2, and V3. Results Of the 53 patients, 38 patients (71.70%) completed the 12-week clinical trial. The mean patient age was 52.24 ± 10.08 years. OABSS and IPSS were significantly improved. The mean voided volume was 147.18 ± 61.84 ml at V1 and 160.03 ± 62.59 ml at V3 ( P < 0.001), and PVR was 64.87 ± 41.11 ml at V1 and 69.05 ± 39.54 ml at V3 ( P = 0.009). Of the 31 patients who underwent UDS, 26 patients (83.87%) had detrusor overactivity (DO) at V1, with a mean value of 107.67 ± 18.13 ml. Of the 26 with DO at V1, 22 (84.62%) still had DO at V3. A mean DO of 131.66 ± 15.27 ml was observed at V3 ( P < 0.001). The most common adverse effects was dry mouths. Conclusions Solifenacin is effective in the treatment of OABS in iNPH patients who underwent the V-P shunt operation. Solifenacin increases bladder capacity causing of DO at UDS. Neurourol. Urodynam. 31:1175-1180, 2012. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Aims To assess the quality of randomized controlled trials (RCTs) published in Neurourology and Urodynamics ( NAU) by using three types of analytical tools. Methods MEDLINE was used to extract RCTs from original articles published in the NAU from 1993 to 2012. The relationship between the number of articles and RCTs with time and that between various factors and the quality of RCTs were analyzed. To analyze the quality of the RCTs, the time period was divided into four sections and three tools were applied (e.g., the Jadad scale, van Tulder scale, and Cochrane Collaboration Risk of Bias Tool [CCRBT]). Results Among the 1,957 original articles, 93 (4.75%) were RCTs. The ratio between the number of NAU and RCTs over time increased. The Jadad score for years 1993-1997 was 3.25 ± 1.71, 1998-2002 was 2.10 ± 0.74, 2003-2007 was 2.09 ± 1.12, and 2008-2012 was 2.80 ± 1.09 ( P = 0.014). The van Tulder scales were 6.25 ± 3.10, 4.40 ± 1.65, 4.97 ± 1.99, and 5.93 ± 1.98, respectively ( P = 0.055). The CCRBT identified a low risk of bias in 1 (25%), 0 (0%), 1 (2.86%), and 5 (11.36%) articles, respectively. Trials with allocation concealment, Institutional review board (IRB) approval, and blinded studies had significantly higher quality than others. Conclusions The quantitative increase of RCT presented in NAU over time was observed but there was no definite qualitative improvement. Effort is required to improve the quality of RCTs published in NAU from the design step. Neurourol. Urodynam. 33:472-474, 2014. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]