The new grasper-integrated single use flexible cystoscope for double J stent removal: evaluation of image quality, flow and flexibility.

BACKGROUND: A new single use digital flexible cystoscope (FC) Isiris α from Coloplast® with an incorporated grasper has been developed to perform double J stent removal. There is a lack of data regarding the comparison of image quality, flexibility and flow between classic cystoscopes and the new Isiris α. MATERIALS AND METHODS: Five different FC were used to compare the image quality, the field of view, the loss of flow and the deflection loss. Two standardized grids, three stones of different composition and a ruler's image were filmed in four standardized different scenarios. These videos were shown to thirty subjects that had to evaluate them. Water outflow was measured in ml/sec in all devices with and without the grasper inside, instruments tip deflection was measured using a software. RESULTS: In the subjective analysis of the image quality Isiris α was the second FC best scored. At 3 cm of distance, the field view of Isiris α was the narrowest. Comparing the water flow in the different FCs, we observed a water flow decrease in all cystoscopes when the grasper was loaded in the working channel. Isiris α deflection and flow increase when the grasper is activated. CONCLUSION: In terms of quality of vision and water flow, the FC Isiris α is comparable to the other digital FC tested. Field of view is narrower. The results displayed a valid alternative to the standard procedure for DJ removal.

Significado clínico de la atrofia proliferativa inflamatoria en la biopsia prostática / Clinical Significance of Proliferative Inflammatory Atrophy in Prostate Biopsy

Introducción: La atrofia proliferativa inflamatoria (PIA) es una lesión frecuentemente observada en biopsias prostáticas, y algunos autores han postulado su implicación en la carcinogénesis prostática. Sin embargo, en la actualidad no se conocen bien los mecanismos que permitirían su transformación neoplásica ni el significado clínico de su hallazgo en una biopsia prostática. Objetivo: Analizar las características de la lesión de PIA, su posible papel en la carcinogénesis prostática y su relación con la agresividad tumoral. Material y método: Se realiza una revisión sistemática de la literatura en PubMed con los términos proliferative inflammatory atrophy o PIA y prostate. Se resumen los hallazgos más relevantes de acuerdo a los objetivos del estudio. Resultados: La PIA parece estar implicada en la carcinogénesis prostática. Esta hipótesis se sustenta en su asociación frecuente con lesiones de cáncer (CaP) y en algunas alteraciones genéticas que le son comunes a la neoplasia intraepitelial de alto grado (HGPIN) y al CaP, fundamentalmente déficit en la expresión de GSTP1 y sobreexpresión de AGR2. Actualmente no existen estudios epidemiológicos que evalúen la incidencia de PIA ni su asociación con HGPIN y CaP. Un solo estudio, realizado por nuestro grupo, ha determinado la incidencia global de PIA en el 30% de las biopsias prostáticas, una menor asociación a CaP que la lesión de HGPIN y una asociación entre PIA y tumores de menor grado e insignificantes. Conclusiones: La PIA comparte alteraciones genéticas con el HGPIN y el CaP. Actualmente no existe evidencia epidemiológica para considerar que la PIA se asocia a mayor incidencia de CaP y los datos genéticos y epidemiológicos disponibles sugieren asociación con tumores poco agresivos

Introduction: Proliferative inflammatory atrophy (PIA) is a frequently observed lesion in prostate biopsies and some authors have postulated its involvement in prostate carcinogenesis. However, the mechanisms that would permit its neoplastic transformation and the clinical significance of its finding in a prostate biopsy are currently not well known. Objective: To analyze the characteristics of the PIA lesion, its possible role in prostate carcinogenesis and its relation with the tumor aggressiveness. Materials and method: A systematic review was made of the literature in PubMed with the terms «proliferative inflammatory atrophy» or «PIA» and «prostate.» The most important findings are summarized in accordance with the study objective. Results: PIA seems to be involved in prostate carcinogenesis. This hypothesis is based on its frequent association to cancer lesions (CaP) and on some genetic alterations that are common to the high grade prostatic intraepithelial neoplasia (HGPIN) and to the CaP, fundamentally deficit in GSTP1 expression and overexpression of AGR2. Currently, there are no epidemiological studies that evaluate the incidence of PIA or its association with HGPIN and CaP. Only one study, carried out by our group, has determined the global incidence of PIA in 30% of the prostate biopsies, a lower association to CaP than the HGPIN lesion and an association between PIA and tumors of lower and insignificant grade. Conclusions: PIA shares genetic alterations with HGPIN and CaP. Currently, there is no epidemiologic evidence to consider that the PIA is associated to a greater incidence of CaP and the genetic and epidemiological data available suggest its association to not very aggressive tumors

Clinical significance of proliferative inflammatory atrophy in prostate biopsy.

INTRODUCTION: Proliferative inflammatory atrophy (PIA) is a frequently observed lesion in prostate biopsies and some authors have postulated its involvement in prostate carcinogenesis. However, the mechanisms that would permit its neoplastic transformation and the clinical significance of its finding in a prostate biopsy is currently not well known. OBJECTIVE: To analyze the characteristics of the PIA lesion, its possible role in prostate carcinogenesis and its relation with the tumor aggressiveness. MATERIAL AND METHOD: A systematic review was made of the literature in PubMed with the terms «proliferative inflammatory atrophy¼ or «PIA¼ and «prostate.¼ The most important findings are summarized in accordance with the study objective. RESULTS: PIA seems to be involved in prostate carcinogenesis. This hypothesis is based on its frequent association to cancer lesions (CaP) and on some genetic alterations that are common to the high grade prostatic intraepithelial neoplasia (HGPIN) and to the CaP, fundamentally deficit in GSTP1 expression and overexpression of AGR2. Currently, there are no epidemiological studies that evaluate the incidence of PIA or its association with HGPIN and CaP. Only one study, carried out by our group, has determined the global incidence of PIA in 30% of the prostate biopsies, a lower association to CaP than the HGPIN lesion and an association between PIA and tumors of lower and insignificant grade. CONCLUSIONS: PIA shares genetic alterations with HGPIN and CaP. Currently, there is no epidemiologic evidence to consider that the PIA is associated to a greater incidence of CaP and the genetic and epidemiological data available suggest its association to not very aggressive tumors.