Search

T2 maps are more vendor independent than other MRI protocols. Multi-echo spin-echo signal decays to a non-zero offset due to imperfect refocusing pulses and Rician noise, causing T2 overestimation by the vendor’s 2-parameter algorithm. The accuracy of the T2 estimate is improved, if the non-zero offset is estimated as a third parameter. Three-parameter Levenberg–Marquardt (LM) T2 estimation takes several minutes to calculate, and it is sensitive to initial values. We aimed for a 3-parameter fitting algorithm that was comparably accurate, yet substantially faster. Our approach gains speed by converting the 3-parameter minimisation problem into an empirically unimodal univariate problem, which is quickly minimised using the golden section line search (GS). To enable comparison, we propose a novel noise-masking algorithm. For clinical data, the agreement between the GS and the LM fit is excellent, yet the GS algorithm is two orders of magnitude faster. For synthetic data, the accuracy of the GS algorithm is on par with that of the LM fit, and the GS algorithm is significantly faster. The GS algorithm requires no parametrisation or initialisation by the user. The new GS T2 mapping algorithm offers a fast and much more accurate off-the-shelf replacement for the inaccurate 2-parameter fit in the vendor’s software.

To date, there has been no evidence regarding the association between urinary sarcosine content and prostate cancer survival. Our main objective was to investigate whether levels of post‐treatment urinary sarcosine are associated with relapse. The inclusion criteria were (in accordance with EAU 2017) as follows: histopathologically verified adenocarcinoma in prostate biopsy cores or specimens from transurethral resection of the prostate (TURP) or prostatectomy for benign prostatic enlargement (BPE) with retained ability to urinate. The median follow‐up was 53 months. In the study, we retrospectively evaluated a cohort of 511 patients with prostate cancer with various risk factors and treatment strategies. Post‐treatment sarcosine levels were elevated in 266 (52%) patients and highly elevated (≥200 nmol/L) in 71 (13%) patients. Urinary sarcosine content was significantly associated with number of relapses that patients experienced, P = 0.002 for sarcosine ≥200 vs ≤30 nmol/L. Multivariate analysis revealed that sarcosine was an independent predictor of recurrent relapses (≥2 relapses with an intermediate period of remission), HR = 3.89 (95% CI 1.29‐11.7) for sarcosine >200 vs

Urinary microRNAs (miRNAs) are emerging as clinically useful tool for early and non‐invasive detection of various types of cancer including bladder cancer (BCA). In this study, 205 patients with BCA and 99 healthy controls were prospectively enrolled. Expression profiles of urinary miRNAs were obtained using Affymetrix miRNA microarrays (2578 miRNAs) and candidate miRNAs further validated in independent cohorts using qRT‐PCR. Whole‐genome profiling identified 76 miRNAs with significantly different concentrations in urine of BCA compared to controls (P

Introduction: Retropulsion, defined as unintended migration of a stone under the influence of the fragmentation device in ureteroscopy (URS) procedures, occurs in 2% to 60% of the cases. Antiretropulsive devices (ARDs) have been studied in experimental and small clinical studies. The current study aims at describing the worldwide usage of ARD and the outcomes related to their usage. Methods: The Clinical Research Office of the Endourological Society URS Global Study enrolled 11,885 patients who underwent URS and stone fragmentation for ureteral and/or renal stones. Of the 11,885 treated patients, 9877 were treated for ureteral stones, and data were available on stone migration and ARD use. Results: Of all procedures, 14.5% were performed with the use of an ARD. Less stone migration (-2.0%; p=0.050), higher stone-free rates (SFRs) (2.8%; p

Radical prostatectomy (RP) is the most common cause of stress urinary incontinence (UI) in men. Several anatomic structures affect or may affect urinary continence - urethral sphincter, levator ani muscle, puboprostatic ligaments, bladder neck, endopelvic fascia, neurovascular bundle - and understanding of the anatomy of pelvic floor and urethra is crucial for satisfactory functional outcome of the procedure. Surgical techniques implemented to improve continence rates include nerve-sparing procedure, bladder neck preservation/plication, urethral length preservation, musculofascial reconstruction, puboprostatic ligaments preservation or seminal vesicle preservation. Perioperative (preoperative and postoperative) pelvic floor muscle training (PFMT) aims to shorten the duration of postoperative UI and thus, improve early continence rates postoperatively. In the review, complex information regarding anatomical, intra- and perioperative factors affecting urinary continence after RP is provided, including description of important anatomical structures, possible implications for surgical technique and evaluation of different PFMT strategies in perioperative period.

Christopher M Dixon,1 Edwin Rijo Cedano,2 Dalibor Pacik,3 Vítězslav Vit,3 Gabriel Varga,3 Lennart Wagrell,4 Thayne R Larson,5 Lance A Mynderse6 1Department of Urology, Phelps Memorial Hospital, Sleepy Hollow, New York, NY, USA; 2Department of Urology, Clinical Canela, La Romana, Dominican Republic; 3Department of Urology, Brno University Hospital, Brno, Czech Republic; 4Urologcentrum, Stockholm, Sweden; 5Institute of Medical Research, Scottsdale, AZ, 6Department of Urology, Mayo Clinic, Rochester, MN,USA Objective: The objective of this study was to assess the effectiveness and safety of convective radiofrequency (RF) water vapor thermal therapy in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH); a pilot study design with 2-year follow-up evaluations.Patients and methods: Men aged ≥45 years with an International Prostate Symptom Score ≥13, a maximum urinary flow rate (Qmax) ≤15 mL/s, and prostate volume 20–120 cc were enrolled in a prospective, open-label pilot study using convective RF water vapor energy with the RezÅ«m System. Patients were followed up for 2 years after transurethral thermal treatment at 3 international centers in the Dominican Republic, Czech Republic, and Sweden. The transurethral thermal therapy utilizes radiofrequency to generate wet thermal energy in the form of water vapor injected through a rigid endoscope into the lateral lobes and median lobe as needed. Urinary symptom relief, urinary flow, quality of life (QOL) impact, sexual function, and adverse events (AEs) were assessed at 1 week, 1, 3, 6, 12, and 24 months. Results: LUTS, flow rate, and QOL showed significant improvements from baseline; prostate volumes were appreciably reduced. Sexual function was maintained and no de novo erectile dysfunction occurred. The responses evident as early as 1 month after treatment remained consistent and durable over the 24 months of study. Early AEs were typically transient and mild to moderate; most were related to endoscopic instrumentation. No procedure related to late AEs were seen. Conclusion: The RezÅ«m System convective RF thermal therapy is a minimally invasive treatment for BPH/LUTS which can be performed in the office or as an outpatient procedure with minimal associated perioperative AEs. It has no discernable effect on sexual function and provides significant improvement of LUTS that remain durable at 2 years. Keywords: benign prostatic hyperplasia, lower urinary tract symptoms, convective RF, water vapor thermal therapy, minimally invasive&nbsp

Introduction: Renal cell carcinoma (RCC) is due to its asymptomatic nature usually diagnosed too late or incidentally during the examination for other indications. There is currently none sufficiently sensitive and reliable biomarker for diagnosis, prediction of the disease development or therapeutic outcome in RCC. Long non-coding RNAs (lncRNAs), RNA molecules regulating gene expression present a group of potential biomarkers as their specific expression profiles have been described in many types of tumors including RCC. Main aim of this study was to analyse global expression profiles of lncRNAs by RNA sequencing, compare them with clinical behaviour of the cancer and to characterize functions of the candidate lncRNAs in vitro. Material and methods: Using next-generation sequencing of RNA from the fresh frozen tissue of 22 patients with RCC we compared expression of lncRNAs in tumor and adjacent non-tumor renal parenchyma. Expression of candidate lncRNAs biomarkers (PVT1, LUCAT1, LINC00982 and SLC16A-AS1) has been validated using qPCR on an independent cohort of 30 patients, results have been statistically evaluated using Mann-Whitney U-test, ROC analysis and were correlated with the clinical stage and Fuhrman grade. Expression of PVT1 was silenced using siRNAs in RCC cell cultures (786-0) and functional characteristics of PVT1 have been studied using MTT test, cell counting and scratch-wound assay. Results: Using the DESeq tool, 1163 deregulated lncRNAs have been identified in patients with RCC when lncRNA profiles of tumors and paired renal parenchyma were compared (538 with increased and 625 with decreased expression levels in tumors). PVT1 (AUC 0,8567, sensitivity 86,67%, specificity 76,67%) and LUCAT1 (AUC 0,7756, sensitivity and specificity 90%) have significantly increased expression and LINC00982 (AUC 0,9578, sensitivity 76,67% and specificity 66,67%) has significantly decreased expression (p < 0,001) also in the validation phase. Statistically significant difference in expression of SLC16A-AS1 has not been observed. Partial effect on migration and proliferation has been observed in PVT1 after the transfection by short interfering RNA. Conclusion: PVT1, LUCAT1 and LINC00982 are a potential diagnostic biomarkers of RCC. Their prognostic potential has not been identified. PVT1 indicated oncogenic functioning in RCC cell lines. This work was supported by Ministry of Health of the Czech Republic, grant nr. NV18-03-00554 and by the Ministry of Education, Youth and Sports of the Czech Republic under the project CEITEC 2020 (LQ1601). All rights reserved. Citation Format: Adela Kubickova, Julia Bohosova, Karolina Trachtova, Jiri Sana, Alexandr Poprach, Michal Stanik, Jan Dolezel, Michal Fedorko, Dalibor Pacik, Marek Svoboda, Ondrej Slaby. Long non-coding RNA PVT1 is a promising diagnostic biomarker with oncogenic functioning in renal cell carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3124.

The hypothesis that dogs can detect malignant tumours through the identification of specific molecules is nearly 30 years old. To date, several reports have described the successful detection of distinct types of cancer. However, is still a lack of data regarding the specific molecules that can be recognized by a dog’s olfactory apparatus. Hence, we performed a study with artificially prepared, well-characterized urinary specimens that were enriched with sarcosine, a widely reported urinary biomarker for prostate cancer (PCa). For the purposes of the study, a German shepherd dog was utilized for analyses of 60 positive and 120 negative samples. Our study provides the first evidence that a sniffer dog specially trained for the olfactory detection of PCa can recognize sarcosine in artificial urine with a performance [sensitivity of 90%, specificity of 95%, and precision of 90% for the highest amount of sarcosine (10 µmol/L)] that is comparable to the identification of PCa-diagnosed subjects (sensitivity of 93.5% and specificity of 91.6%). This study casts light on the unrevealed phenomenon of PCa olfactory detection and opens the door for further studies with canine olfactory detection and cancer diagnostics.

Purpose To provide information about the role of microRNAs in the pathogenesis of renal cell carcinoma (RCC) and their diagnostic and prognostic utility as cancer biomarkers. Methods A literature search was performed in the PubMed and Web of Science databases using the keywords “renal cancer/renal cell carcinoma/kidney cancer” and “miR*/miRNA*/microRNA*”. Articles dealing with the role of miRNAs in the pathogenesis of RCC, diagnostic miRNAs and prognostic miRNAs were separated. Results MiRNAs act both as oncogenes and tumor suppressors. They regulate apoptosis, cell growth, migration, invasion, proliferation, colony formation and angiogenesis through target proteins involved in several signaling pathways, and they are involved in key pathogenetic mechanisms such as hypoxia (HIF/VHL dependent) and epithelial-to-mesenchymal transition. Differentially expressed miRNAs can discriminate either tumor tissue from healthy renal tissue or different RCC subtypes. Circulating miRNAs are promissing as diagnostic biomarkers of RCC. Information about urinary miRNAs associated with RCC is sparse. Detection of a relapse is another implication of diagnostic miRNAs. The expression profiles of several miRNAs correlate with the prognosis of RCC patients. Comparison between primary tumor tissue and metastasis may help identify high-risk primary tumors. Finally, response to target therapy can be estimated thanks to differences in miRNA expression in tissue and serum of therapy-resistant versus therapy-sensitive patients. Conclusions Our understanding of the role of microRNAs in RCC pathogenesis has been increasing dramatically. Identification and validation of their gene targets may have direct impact on developing microRNA-based anticancer therapy. Several microRNAs can serve as diagnostic and prognostic biomarkers.

Carcinoma of the prostate is a commonly occurring malignant tumour in men and is a common cause of death. Early diagnosis and therapy is crucial for the successful treatment of this serious disease. It is therefore desirable to develop a sufficiently reliable, minimally invasive, and inexpensive method of diagnosing prostate cancer, which would usefully supplement the diagnostic techniques currently in common use (digital rectal examination, measuring the prostate-specific antigen level in serum, transrectal ultrasonography). This article describes in detail the methodology of a new technique for intensive training aimed at developing the dog’s olfactory abilities to diagnose carcinoma of the prostate in men while the animal is still young. At the same time, the rate of success in establishing the diagnosis of prostate cancer in men using this method was evaluated based on the identification of urine samples from patients in whom the disease was histologically confirmed. The results of our study demonstrate that the diagnosis of prostate cancer in men using the olfactory abilities of a specially trained dog can be considered a reliable, non-invasive, and relatively inexpensive method of diagnosing carcinoma of the prostate.

Pyeloduodenal fistula is a communication between renal pelvis and duodenum. As a result of its rare occurence, almost all data on pyeloduodenal fistulas come from case reports only. Approximately, 100 cases have been reported so far. The most common cause is inflammation of the kidney and perirenal space, usually following upper urinary tract obstruction. The symptoms may be non-specific and long lasting. Surgical treatment comprising nephrectomy and primary closure of duodenum has been considered the treatment of choice. With the advent of percutaneous procedures, the number of pyeloduodenal fistulas treated conservatively has been increasing.

Introduction: Urinary microRNAs (miRNAs) are emerging as a clinically useful tool for early and non-invasive detection of various types of cancer. The aim of this study was to evaluate whether let-7 family miRNAs differ in their urinary concentrations between renal cell carcinoma (RCC) cases and healthy controls. Materials and methods: In the case-control study, 69 non-metastatic clear-cell RCC patients and 36 gender/age-matched healthy controls were prospectively enrolled. Total RNA was purified from cell-free supernatant of the 105 first morning urine specimens. Let-7 family miRNAs were determined in cell-free supernatant using quantitative miRNA real-time reverse-transcription PCR and absolute quantification approach. Results: Concentrations of all let-7 miRNAs (let-7a, let-7b, let-7c, let-7d, let-7e and let-7g) were significantly higher in urine samples obtained from RCC patients compared to healthy controls (P < 0.001; P < 0.001; P = 0.005; P = 0.006; P = 0.015 and P = 0.002, respectively). Subsequent ROC analysis has shown that let-7a concentration possesses good ability to differentiate between cases and controls with area under curve being 0.8307 (sensitivity 71%, specificity 81%). Conclusions: We have shown that let-7 miRNAs are abundant in the urine samples of patients with clear-cell RCC, and out of six let-7 family members, let-7a outperforms the others and presents promising non-invasive biomarker for the detection of RCC.

Objective To evaluate by magnetic resonance imaging the physical effects of convective thermal energy transfer with water vapor as a means of treating lower urinary tract symptoms due to benign prostatic hyperplasia. Methods Sixty-five men with lower urinary tract symptoms were treated with the Rezūm System by transurethral intraprostatic injection of water vapor. A group of 45 of these men consented to undergo a series of gadolinium-enhanced magnetic resonance imagings of the prostate after treatment to monitor the size and location of ablative lesions, their time course of resolution, and the corresponding change in prostate tissue volume. Visualization was conducted at 1 week, 1, 3, and 6 months after treatment. Results Outcomes were available for 44 patients. Convective thermal lesions were limited to the transition zone and correlated with targeted treatment locations. At 1 week after treatment, the mean volume of ablative lesions was 8.2 cm3 (0.5-24.0 cm3). At 6 months, whole prostate volume was reduced by a mean of 28.9% and transition zone volume by 38.0% as compared with baseline 1-week images. At 3 and 6 months after treatment, the lesion volumes had reduced by 91.5% and 95.1%, respectively. Lesions remained within the targeted treatment zone without compromising integrity of the bladder, rectum, or striated urinary sphincter. Conclusion This imaging study confirms the delivery of convective water vapor technology to create thermal lesions in the prostate tissue. Lesions generated underwent near complete resolution by 3 and 6 months after treatment with a concomitant one-third reduction in overall prostate and transition zone volumes.

To assess 1-year efficacy and safety data from pilot trials of the Rezūm System water vapor to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).A total of 65 men with symptoms of moderate to severe BPH were enrolled in pilot studies at centers in the Dominican Republic, the Czech Republic, and Sweden. Each patient was treated with transurethral delivery of sterile water vapor (steam). International Prostate Symptom Score (IPSS), peak urinary flow (Qmax), quality of life (QoL), postvoid residual, International Index of Erectile Function, and prostate-specific antigen were evaluated at 1 week and 1, 3, 6, and 12 months post-treatment. Safety was also assessed.Statistically significant clinical improvements at 1, 3, 6, and 12 months were reported for IPSS (decreased by 6.8, 13.4, 13.1, and 12.5 points, respectively) and Qmax (increased by 2.0, 4.7, 4.3, and 4.6 mL/sec, respectively). At 12 months, these results equated to a 56% improvement in IPSS (P.001) and an 87% improvement in Qmax (P.001). QoL also improved at 12 months with a 61% improvement. Sexual function was maintained. Most of the adverse events (AEs) were related to endoscopic instrumentation and were of short duration. One case of urinary retention was classified as a procedure/device-related serious AE.The Rezūm System provides effective relief of LUTS associated with BPH at 1 year. The procedure is safe with an acceptable side effect profile.

Renal colic causes excruciating pain that provides a good clinical model of acute pain for the development of new analgesics.The purpose of the study was to compare the analgesic efficacy and tolerability of cizolirtine citrate and metamizol sodium in adult acute renal colic.This Phase II, randomized, double-blind, clinical pilot study was conducted in the emergency departments of 6 general hospitals in the Czech Republic between October 2000 and February 2001. Male and female patients aged 18 to 65 years and presenting with hematuria and moderate to severe pain due to suspected renal colic starting within the 24 hours before presentation were eligible. Patients were randomized to receive a single IV dose of cizolirtine 350 mg or metamizol 2,500 mg, administered by slow infusion over 15 minutes. Both doses were maximal for the respective drugs to attain adequate analgesia. Use of rescue medication with butorphanol was allowed 30 minutes after study drug administration. Pain intensity was assessed at various time points during the following 360 minutes using a 100-mm visual analog scale (VAS) and a verbal categoric scale. In addition, a specific verbal categoric scale was used to rank pain relief. Physical examinations, laboratory tests, and questioning for adverse events addressed drug tolerability.Sixty-four patients (50 men, 14 women; mean [SD] age, 44.21 [12.29] years; mean [SD] body mass index, 25.97 [3.38] kg/m(2)) were enrolled. Physical examination findings and mean VAS pain intensity scores at baseline (mean [SD], 79.42 [7.89] mm and 82.59 [10.50] mm in the cizolirtine and metamizol groups, respectively) were similar in both groups. After 30 minutes, the mean (SD) scores were 33.84 (25.15) mm and 25.41 (24.51) mm, respectively. This difference was not statistically significant, and the noninferiority of cizolirtine with respect to the comparator could not be established. However, the proportion of patients that showed satisfactory pain relief (ie, decrease ofor = 50% in VAS pain intensity score compared with baseline) at 30 minutes in the cizolirtine group was fairly high (64.5%), which means relevant analgesic activity. Both treatments were well tolerated; 6 adverse events were reported in 5 patients (7.8%), and all were considered as not treatment related.Although this limited pilot study did not include an internal measure of sensitivity, relevant pain reduction was shown in the population of patients with suspected renal colic undergoing treatment with cizolirtine, suggesting the presence of analgesic activity. However, the efficacy of cizolirtine was found to be similar to that of metamizol. Treatments were well tolerated.

Primary transitional cell carcinoma (TCC) of the vagina represents an extremely rare neoplasm and is associated with multicentric TCC of the urinary tract in all described cases. A case of multicentric TCC of the vagina and the left ureter in a 73-year-old woman is reported. Immunohistochemical analysis of cytokeratin expression was performed. Immunohistochemistry proved to play an important role in the differential diagnosis of vaginal TCC, supported the morphological diagnosis of TCC, and largely excluded the diagnosis of vaginal papillary carcinoma with transitional features as a morphological variant of squamous cell carcinoma. Subsequent urological examination revealed multicentric TCC of the left ureter. During the follow up, the metastases of the vaginal TCC into the regional inguinal lymph nodes were diagnosed, suggesting that indolent clinical course is not a rule in this type of tumor.

The authors report on the treatment of lower-pole caliceal nephrolithiasis with extracorporeal shockwave lithotripsy (SWL) using the Czech-made Medilit M-5 lithotripter. In 310 patients, they have performed 452 treatments and evaluated the results 3 months after the last session using plain radiographs and ultrasound examination. The effectiveness of treatment and the success rate of SWL decreased with increasing size of stones: with stones20 mm, it declined to 30%. This poor success rate was attributable not only to the size of the concrement, but also to its location in a lower calix, which is unfavorable for the passage of fragments. For big lower-pole caliceal stones (20 mm in the longest diameter), the authors recommend percutaneous nephrolithotomy as the primary management method, the effectiveness of which does not depend on the size of the stone. The success rate achieved in treating the lower-pole caliceal lithiasis using the Medilit M-5 machine was 61.3%, similar to that achieved with other lithotripters.

Spravně provedena in vitro biopsie podle Videňskeho nomogramu ukazuje klinicky signifikantni nador pouze u 40.43% pacientů s klinicky signifikantnim nadorem zjistěným z definitivniho preparatu po radikalni prostatektomii. Tyto nalezy mohou upozornit na realnou sanci podhodnoceni klinicky signifikantniho nadoru

local injection anesthesia provides a significant pain reduction during prostate biopsy. Its replacement by the anesthetic suppository alone is not sufficient, however combination of this two mwethods leads ti further significant reduction of pain suffered especially in probe insertion

The authors did not observe an increase in the incidence of infectious complications following PB in past five years. Our standard antibiotic prophylaxis with fluorochinolone + metronidazol has proved to be still effective in more than 97% of PBs.On the other hand, in cases of failed prophylaxis, we noticed a substantial increase in the antibiotic resistance to the commonly used antibiotics. This should lead us to an aggressive treatment and early administration of wide spectrum antibiotics in patients suffering serious septic complications (meropenem,ceftazidime, tazobactam + ticarcilin).