Publications without Fulltext
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
Browse
15 results
Search Results
Publication Metadata only Can we predict and manage persistent storage and voiding LUTS following bladder outflow resistance reduction surgery in men? ICI-RS 2023(Wiley, 2024) Hashim, Hashim; Malde, Sachin; Sinha, Sanjay; Sahai, Arun; Selai, Caroline; Agro, Enrico Finazzi; Abrams, Paul; Wein, Alan; Tarcan, Tufan; Acar, Ömer; ; School of Medicine;Aims Lower urinary tract symptoms (LUTS) persist in up to 50% of patients after bladder outflow resistance reduction surgery (BORRS) in men. Our think tank aims to address the predictive factors for persistent LUTS after BORRS and to propose the recommendations for future research to enable improved better patient counseling and selection by more accurate prediction of treatment outcome.MethodsA think tank of ICI-RS gathered in 2023, Bristol, UK, to discuss the pre and postsurgical clinical and urodynamic evaluation of men undergoing BORRS and whether it is possible to predict which men will have persistent LUTS after BORRS.ResultsOur think tank agrees that due to the multifactorial, and still not fully understood, etiology of male LUTS it is not possible to precisely predict in many men who will have persistent LUTS after BORRS. However, severe storage symptoms (overactive bladder, OAB) in association with low volume and high amplitude detrusor overactivity and low bladder capacity in preoperative urodynamics, increase the likelihood of persistent OAB/storage symptoms after BORRS. Furthermore, patients who are clearly obstructed and have good bladder contractility on preoperative pressure flow studies do better postoperatively compared to their counterparts. However, the benefit of pressure flow studies is decreased in patients who do not acceptably void during the study. Poor voiding after BORRS may occur due to persistent obstruction or detrusor underactivity.ConclusionFuture research is needed to increase our understanding of why male LUTS persist after surgery, and to enable better patient selection and more precise patient counseling before BORRS.Publication Metadata only Can we predict whether a man with acute or chronic urinary retention will void after bladder outflow resistance reduction surgery? ICI-RS 2023(Wiley, 2024) Malde, Sachin; Sinha, Sanjay; Sahai, Arun; Perrouin-Verbe, Marie-Aimee; Hashim, Hashim; Agro, Enrico Finazzi; Wein, Alan; Abrams, Paul; Tarcan, Tufan; Acar, Ömer; ; School of Medicine;Aims To address the predictive factors of a successful voiding after bladder outflow resistance reduction surgery (BORRS) in men presenting with acute or chronic urinary retention (UR).MethodsA think tank (TT) of ICI-RS was gathered in 2023, Bristol, UK, to discuss several aspects of the problem, such as the pathophysiology of UR, the clinical and urodynamic evaluation of men with UR and whether it is possible to predict which men will be able to successfully void after treatment with contemporary surgical options.ResultsThe TT agreed that successful voiding after BORRS depends on several factors but that a strong recommendation cannot be made regarding preoperative evaluation and whether there are predictive factors of success because of the heterogeneity of patients and methodology in published trials. The diagnosis of obstruction in men with UR may be challenging when there is apparent reduced detrusor contraction during urodynamic studies. Even in the absence of bladder contractility there is documentation of such cases that have voided adequately after BORRS. Still, detrusor underactivity and inadequate relief of prostatic obstruction are the main causes of an unsuccessful voiding after BORRS. Conventional resection and enucleation methods remain the most successful surgeries in relieving UR in men, whereas the efficacy of minimally invasive surgical treatments needs to be assessed further.ConclusionResearch is needed to understand the pathophysiology of UR and the predictors of successful voiding after different types of BORRS in men with UR.Publication Metadata only How do we make progress in phenotyping patients with lower urinary tract such as overactive bladder and underactive detrusor, including using urine markers and microbiome data, to personalize therapy? ICI-RS 2023 - Part 2(Wiley, 2024) Agro, Enrico Finazzi; Rosato, Eleonora; Wagg, Adrian; Sinha, Sanjay; Fede Spicchiale, Claudia; Serati, Maurizio; Mancini, Vito; de Rijk, Mathijs; Wein, Alan; Abrams, Paul; Bou Kheir, George; Tarcan, Tufan; ; School of Medicine;IntroductionOveractive bladder (OAB) and underactive bladder (UAB) could be associated with metabolic syndrome, affective disorders, sex hormone deficiency, changes in urinary microbiota, functional gastrointestinal disorders, or autonomic nervous system dysfunction.ObjectivesThe aim of this Think Tank was to provide a guide on how to investigate OAB and/or detrusor underactivity (DU) patients to better clarify the underlying pathophysiology and possibly personalize the treatment.MethodsA compendium of discussion based on the current evidence related to phenotyping patients with OAB or DU using urodynamic tests, functional neuro-imaging, urinary markers, and microbiome.Results and ConclusionsThe article emphasizes the critical significance of adopting a comprehensive yet tailored approach to phenotyping patients with lower urinary tract (LUT) symptoms, such as OAB and UAB. The intricate interplay between the LUT and various factors, metabolic, neurological, psychological, and gastrointestinal can define unique LUT profiles, enabling personalized therapies to replace the one-size-fits-all approach.Publication Metadata only Urinary biomarkers in children with neurogenic and non-neurogenic lower urinary tract dysfunction: a systematic review and meta-analysis(Wiley, 2024) Sekerci, Cagri Akin; Yucel, Selcuk; Tarcan, Tufan; ; School of Medicine;Aim The aim of this systematic review is to assess urinary biomarkers studied in children with neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD).Materials and MethodsThe systematic review was conducted in accordance with the PRISMA guidelines. The screening was performed on PUBMED without any publication date limitation. Only original articles were included. Parameters related to the following topics were obtained: study design, characteristics of participants, number of participants, age, control group, types of biomarkers, measurement technique in urine, subgroup analysis, urodynamic findings, and outcome. Dutch Cochrane Checklist (DCC) and level of evidence by EBRO platform were used for quality assessment. Meta-analysis was performed with the Comprehensive Meta-Analysis Version 4 program.ResultsA total of 494 studies were screened and 16 studies were included. 11 (68.75%) were conducted in children with non-neurogenic LUTD and 5 (31.25%) neurogenic LUTD. Nerve growth factor (NGF) was evaluated in 12 studies, brain-derived neurotrophic factor (BDNF) in 5, Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) in 2, transforming growth factor beta-1 (TGF Beta-1) in 2, neutrophil gelatinase-associated lipocalin (NGAL) in 1, and Aquaporin-2 in 1. According to DCC, 10 (62.5%) articles were evaluated on 4 (37.5%) items and 4 articles on 5 items. The average score was 3.91+/-0.56. The level of evidence was found as B for 13 (81.25%) articles and C for 3 (18.75%). In meta-analysis, urinary NGF levels in children with non-neurogenic LUTS were significantly higher than in the healthy control group (Hedges's g = 1.867, standard error = 0.344, variance = 0.119, p = 0.0001).ConclusionUrinary biomarkers are promising for the future with their noninvasive features. However, prospective studies with larger sample sizes are needed to better understand the potential of urinary biomarkers to reflect urodynamic and clinical findings in children with LUTD.Publication Metadata only Evaluation of new treatments for benign prostatic obstruction: ICI-RS 2023(Wiley, 2023) Hashim, Hashim; Acar, Omer; Malde, Sachin; Wein, Alan; Abrams, Paul; Tarcan, Tufan; ; School of Medicine;Aims To address how invasive therapies for benign prostatic obstruction (BPO) have been evaluated, what their effect is on BPO, if they can prevent progression to BPO and how new therapies need to be evaluated before implementation into clinical practice.MethodsThe think tank conducted a literature review and looked at the previous and current American Urological Association, European Association of Urology and the International Consultation on Urological Diseases guidelines to see what procedures have been used to treat BPO. They then assessed whether trials have been conducted before implementation of the procedures and whether they have been compared to a "gold" standard treatment. The use of urodynamics has also been addressed in the think tank in relation the clinical trials as well as terminology.ResultsGuidelines vary in the use of terminology when it comes to BPO with some continuing to use the term benign prostatic hyperplasia (BPH). There are several procedures for example, TUNA, which have become obsolete although continues to be mentioned in the guidelines until recently. Majority of procedures have been introduced without comparing to "gold" standard treatment and without any long-term data. There continues to be many unknowns with regard to the success of some of the BPO procedures and why some of the adverse events develop.ConclusionThere needs to be more robust long-term clinical trials conducted of new BPO therapies, with men who have both lower urinary tract symptoms and urinary retention, before introduction into clinical practice.Publication Metadata only How do we make progress in phenotyping patients with LUT such as OAB and underactive detrusor, including using urine markers and microbiome data, in order to personalize therapy? ICI-RS 2023 - Part 1(Wiley, 2024) Agro, Enrico Finazzi; Rosato, Eleonora; Wagg, Adrian; Sinha, Sanjay; Spicchiale, Claudia Fede; Serati, Maurizio; Mancini, Vito; de Rijk, Mathijs; Wein, Alan; Abrams, Paul; Kheir, George Bou; Tarcan, Tufan; ; School of Medicine;IntroductionOveractive bladder (OAB) and Underactive bladder (UAB) could be associated with metabolic syndrome, affective disorders, sex hormone deficiency, changes in urinary microbiota, functional gastrointestinal disorders, or autonomic nervous system dysfunction.ObjectivesThe aim of this Think Tank was to provide a guide on how to investigate OAB and/or detrusor underactivity (DU) patients to better clarify the underlying pathophysiology and possibly personalize the treatment.MethodsA compendium of discussion based on the current evidence related to phenotyping patients with OAB or DU investigating metabolic, neurogical, psychological and gastrointestinal aspects with the aim to personalize the treatment.Results and ConclusionsThe article emphasizes the critical significance of adopting a comprehensive yet tailored approach to phenotyping patients with lower urinary tract symptoms, such as OAB and UAB. The intricate interplay between the lower urinary tract and various factors, metabolic, neurological, psychological, and gastrointestinal can define unique LUT profiles, enabling personalized therapies to replace the one-size-fits-all approach.Publication Metadata only Safety and efficacy of an α1-blocker plus mirabegron compared with an α1-blocker plus antimuscarinic in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia and overactive bladder: a systematic review and network meta-analysis(Wiley, 2024) Herschorn, Sender; Jiang, Yuan-Hong; Chung, Eric; Abdul Hadi, Farid; Steup, Achim; Sumarsono, Budiwan; Tarcan, Tufan; ; School of Medicine;Aim: Antimuscarinics and the beta 3-adrenoreceptor agonist, mirabegron, are commonly used for treating patients with overactive bladder (OAB) and alpha(1)-adrenoreceptor antagonists (alpha(1)-blockers) are the main pharmacological agents used for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). As these conditions commonly occur together, the aim of this systematic review was to identify publications that compared the use of an alpha(1)-blocker plus mirabegron with an alpha(1)-blocker plus antimuscarinic in men with LUTS secondary to BPH and OAB. A meta-analysis was subsequently conducted to explore the safety and efficacy of these combinations. Methods: Included records had to be from a parallel-group, randomized clinical trial that was >= 8 weeks in duration. Participants were male with LUTS secondary to BPH and OAB. The indirect analyses that were identified compared an alpha(1)-blocker plus OAB agent with an alpha(1)-blocker plus placebo. The PubMed/Medical Literature Analysis and Retrieval System Online, the Excerpta Medica Database, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry were searched for relevant records up until March 5, 2020. Safety outcomes included incidences of overall treatment-emergent adverse events (TEAEs) and urinary retention, postvoid residual volume, and maximum urinary flow (Q(max)). Primary efficacy outcomes were micturitions/day, incontinence episodes/day, and urgency episodes/day, and secondary outcomes were Overactive Bladder Symptom Score and International Prostate Symptom Score. A Bayesian network meta-analysis approach was used for the meta-analysis. Results: Out of a total of 1039 records identified, 24 were eligible for inclusion in the meta-analysis. There were no statistically significant differences between the alpha(1)-blocker plus mirabegron and alpha(1)-blocker plus antimuscarinic groups in terms of the comparisons identified for all the safety and efficacy analyses conducted. Numerically superior results were frequently observed for the alpha(1)-blocker plus mirabegron group compared with the alpha(1)-blocker plus antimuscarinic group for the safety parameters, including TEAEs, urinary retention, and Q(max). For some of the efficacy parameters, most notably micturitions/day, numerically superior results were noted for the alpha(1)-blocker plus antimuscarinic group. Inconsistency in reporting and study variability were noted in the included records, which hindered data interpretation. Conclusion: This systematic review and meta-analysis showed that an alpha(1)-blocker plus mirabegron and an alpha(1)-blocker plus antimuscarinic have similar safety and efficacy profiles in male patients with LUTS secondary to BPH and OAB. Patients may, therefore, benefit from the use of either combination within the clinical setting.Publication Metadata only Does sexual intercourse position have a role in occurrence of coital urinary incontinence?(Springer, 2024) Tarhan, Fatih; Erbay, Erkan; Sevinc, Burcu Hanci; Tarcan, Tufan; School of MedicineIntroduction and Hypothesis This study was aimed at investigating the hypothesis that sexual intercourse positions may have an impact on the occurrence of coital urinary incontinence (CUI) in women. Methods This case-control observational study enrolled 360 married, heterosexual, sexually active female participants with CUI. Each patient was evaluated using medical and sexual histories, questionnaires, physical examinations, and laboratory tests, including urodynamics. Participants were asked whether or not their intercourse positions had an impact on the occurrence of their CUI. Patients with intercourse position-dependent CUI were included in group 1, and those independent of it were allocated to group 2. The clinic and laboratory findings of the patient groups were compared. Results The patients' mean age was 47.24 +/- 0.57 years. Of these women, 28.9% (n = 104) were in group 1, and 71.1% (n = 256) were in group 2. Group 1 had a lower mean age, body mass index, Charlson comorbidity index, number of urinary incontinence episodes, severity of CUI and incontinence, and pad weight than group 2 (p < 0.05). The rates of detrusor overactivity and penetration type of CUI were higher in group 1 than in group 2 (p < 0.0009, p = 0.009 respectively). According to logistic regression analysis, the likelihood of sexual position-related CUI was 3.5 times higher in women with detrusor overactivity. Conclusions In certain patients, intercourse position is associated with the occurrence of CUI. This condition seems to be related to detrusor overactivity and is inversely associated with incontinence severity. However, further studies are necessary to explain this phenomenon.Publication Metadata only Survival of stage III non-seminoma testis cancer patients versus simulated controls, according to race/ethnicity(Wiley, 2024) Morra, Simone; Cano Garcia, Cristina; Piccinelli, Mattia Luca; Tappero, Stefano; Barletta, Francesco; Incesu, Reha-Baris; Scheipner, Lukas; Baudo, Andrea; Tian, Zhe; de Angelis, Mario; Mirone, Vincenzo; Califano, Gianluigi; Celentano, Giuseppe; Saad, Fred; Shariat, Shahrokh F.; Chun, Felix K. H.; de Cobelli, Ottavio; Musi, Gennaro; Terrone, Carlo; Briganti, Alberto; Ahyai, Sascha; Carmignani, Luca; Longo, Nicola; Karakiewicz, Pierre I.; Tilki, Derya; School of MedicineBackground It is unknown whether 5-year overall survival (OS) differs and to what extent between the American Joint Committee on Cancer stage III non-seminoma testicular germ cell tumor (NS-TGCT) patients and simulated age-matched male population-based controls, according to race/ethnicity groups. Methods We identified newly diagnosed (2004-2014) stage III NS-TGCT patients within the Surveillance Epidemiology and End Results database 2004-2019. For each case, we simulated an age-matched male control (Monte Carlo simulation), relying on Social Security Administration (SSA) Life Tables with 5 years of follow-up. We compared OS rates between stage III NS-TGCT patients and simulated age-matched male population-based controls, according to race/ethnicity groups (Caucasian, Hispanic, Asian/Pacific Islander and African American). Both, cancer-specific mortality (CSM) and other-cause mortality (OCM) were computed. Results Of 2054 stage III NS-TGCT patients, 60% were Caucasians versus 33% Hispanics versus 4% Asians/Pacific Islanders versus 3% African Americans. The 5-year OS difference between stage III NS-TGCT patients versus simulated age-matched male population-based controls was highest in Asians/Pacific Islanders (64 vs. 99%, Delta = 35%), followed by African Americans (66 vs. 97%, Delta = 31%), Hispanics (72 vs. 99%, Delta = 27%), and Caucasians (76 vs. 98%, Delta = 22%). The 5-year CSM rate was highest in Asians/Pacific Islanders (32%), followed by African Americans (26%), Hispanics (25%), and Caucasians (20%). The 5-year OCM rate was highest in African Americans (8%), followed by Caucasians (4%), Asians/Pacific Islanders (4%), and Hispanics (2%). Conclusion Relative to SSA Life Tables, the highest 5-year OS disadvantage applied to stage III NS-TGCT Asian/Pacific Islander race/ethnicity group, followed by African American, Hispanic and Caucasian, in that order.Publication Metadata only Can the Briganti 2019 nomogram be modified to predict lymph node metastasis risk in patients with prostate cancer detected with in-bore biopsy?(Wiley, 2024) Madendere, Serdar; Kılıç, Mert; Vural, Metin; Gürses, Bengi; Armutlu, Ayşe; Kulaç, İbrahim; Tarım, Kayhan; Esen, Barış; Aykanat, İbrahim Can; Veznikli, Mert; Canda, Abdullah Erdem; Balbay, Mevlana Derya; Baydar, Dilek Ertoy; Kordan, Yakup; Esen, Tarık; Koç University RMK Academy of Interventional Medicine, Education, and Simulation (RMK AIMES) / Koç Universitesi RMK İleri Düzey Girişimsel Tıp, Eğitim ve Simülasyon Merkezi (RMK AIMES); School of Medicine; Koç University HospitalObjectives: We aimed to modify the Briganti 2019 nomogram and to test whether it is valid for patients who were diagnosed with prostate cancer through in-bore prostate biopsies. Methods: Data for 204 patients with positive multiparametric prostate MRI and prostate cancer identified either by mpMRI-cognitive/software fusion or in-bore biopsy and who underwent robot-assisted radical prostatectomy and extended pelvic lymph node dissection between 2012 and 2023 were retrospectively analyzed. The Briganti 2019 nomogram was applied to the mpMRI-cognitive/software fusion biopsy group (142 patients) in the original form, and then, two modifications were tested for the targeted component. Original and modified scores were compared. These modifications were adapted for the in-bore biopsy group (62 patients). The final histopathologic stage was regarded as the gold standard. Results: Nodal metastases were identified in 18/142 (12.6%) of mpMRI-cognitive/software fusion biopsy patients and 8/62 (12.9%) of the in-bore biopsy patients. In the mpMRI-cognitive/software fusion biopsy group, tumor size/core size (%) of targeted biopsy cores and positive core percentage on systematic biopsy were significant parameters for lymph node metastasis based on univariate logistic regression analyses (p < 0.05). With the modifications of these parameters for the in-bore biopsy group, V1 modification of the Briganti 2019 nomogram provided 100% sensitivity and 31.5% specificity (AUC:0.627), while V2 modification provided 75% sensitivity and 46.3% specificity (AUC:0.645). Conclusions: Briganti 2019 nomogram may be modified by utilizing tumor size/core size (%) for targeted biopsy cores instead of positive core percentage on systematic biopsy or by not taking both parameters into consideration to detect node metastasis risk of patients diagnosed with in-bore biopsies.