Transurethral columnar balloon dilation of the prostate combined with holmium laser incision for bladder neck contracture in day-surgery mode.

The study aimed to investigate the clinical effect of transurethral columnar balloon dilation of the prostate combined with holmium laser in the treatment of bladder neck contracture (BNC). This retrospective study included 41 patients with BNC, who had been treated with transurethral columnar balloon dilation and holmium laser in our hospital from June 2020 to June 2022. Admission, operation, and discharge of all the patients were completed in 24 h. The patients' satisfaction, postoperative complications, and chronic pain after operation were followed up. Clinical parameters, such as International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), quality of life (QoL), and post-void residual volume (PVR) in pre-operation, 1 month and 6 months after operation were recorded. All patients underwent the operations successfully. Six patients experienced urge incontinence and one patient experienced recurrence of BNC after 12 months. At 1 month and 6 months after the operation, IPSS, QoL, PVR, and Qmax of the patients were significantly better than those before the operation (P < 0.05). Transurethral columnar balloon dilation of the prostate combined with holmium laser can effectively treat BNC with simple performance and satisfactory clinical effects. It is a minimally invasive treatment that can be conducted by simple day surgery.

PIWI Proteins and PIWI-Interacting RNA: Emerging Roles in Cancer.

P-Element induced wimpy testis (PIWI)-interacting RNAs (piRNAs) are a type of noncoding RNAs (ncRNAs) and interact with PIWI proteins. piRNAs were primarily described in the germline, but emerging evidence revealed that piRNAs are expressed in a tissue-specific manner among multiple human somatic tissue types as well and play important roles in transposon silencing, epigenetic regulation, gene and protein regulation, genome rearrangement, spermatogenesis and germ stem-cell maintenance. PIWI proteins were first discovered in Drosophila and they play roles in spermatogenesis, germline stem-cell maintenance, self-renewal, retrotransposons silencing and the male germline mobility control. A growing number of studies have demonstrated that several piRNA and PIWI proteins are aberrantly expressed in various kinds of cancers and may probably serve as a novel biomarker and therapeutic target for cancer treatment. Nevertheless, their specific mechanisms and functions need further investigation. In this review, we discuss about the biogenesis, functions and the emerging role of piRNAs and PIWI proteins in cancer, providing novel insights into the possible applications of piRNAs and PIWI proteins in cancer diagnosis and clinical treatment.

Circular RNAs: A novel type of biomarker and genetic tools in cancer.

Circular RNAs (circRNAs) are a novel type of universal and diverse endogenous noncoding RNAs (ncRNAs) and they form a covalently closed continuous loop without 5' or 3' tails unlike linear RNAs. Most circRNAs are presented with characteristics of abundance, stability, conservatism, and often exhibiting tissue/developmental-stage-specific expression. CircRNAs are generated either from exons or introns by back splicing or lariat introns. CircRNAs play important roles as miRNA sponges, gene transcription and expression regulators, RNA-binding protein (RBP) sponges and protein/peptide translators. Emerging evidence revealed the function of circRNAs in cancer and may potentially serve as a required novel biomarker and therapeutic target for cancer treatment. In this review, we discuss about the origins, characteristics and functions of circRNA and how they work as miRNA sponges, gene transcription and expression regulators, RBP sponges in cancer as well as current research methods of circRNAs, providing evidence for the significance of circRNAs in cancer diagnosis and clinical treatment.

Five-year follow-up after conversion from calcineurin inhibitor to sirolimus-based treatment in kidney transplant patients with chronic allograft nephropathy.

Chronic allograft nephropathy (CAN) is a major cause of graft loss in long-term kidney transplant recipients. To identify the safety and efficacy of conversion from calcineurin inhibitors (CNI) to sirolimus (SRL) in patients with CAN, we investigated 92 biopsy demonstrated CAN patients during a 5-year follow-up.45 patients were converted to sirolimus treatment (SRL group) and remaining 47 patients continued CNI immunosuppression (CNI group). Renal function, proteinuria, hepatic function, lipid level and blood routine examination were observed for 60 months in each group. During the period of conversion, serum creatinine was superior in SRL group to CNI group. It dropped significantly from (174.0 ± 62.8) umol/L to (150.7 ± 83.4) umol/L in SRL group whereas increased to (200.9 ± 73.5) umol/L in CNI group (P < 0.05). However, SRL group showed increased proteinuria, triglycerides and decreased Plt (P < 0.05). We also found those patients in SRL group with a good baseline of renal function (serum creatinine < 200 umol/L or proteinuria < 800 mg/day at conversion) would ameliorate the impaired renal function from CAN at 60 months. In conclusion, it is safe and effective to convert from CNI to SRL for patients with CAN in our long-term observation. Early conversion is associated with an improvement of renal function.

Impacts of histological prostatitis on sexual function and lower urinary tract symptoms in patients with benign prostatic hyperplasia.

OBJECTIVE: To investigate the correlation of histological prostatitis with sexual function (erectile dysfunction [ED]) and lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). METHODS: A retrospective analysis of patients with BPH who received surgical treatment (from May 1, 2012 to November 30, 2012) was conducted, consisting of 80 patients with uncomplicated BPH and 80 patients with BPH plus histological prostatitis. The International Index of Erectile Function (IIEF-5) symptom score and the International Prostate Symptom Score (IPSS) before surgery were calculated. Preoperative sexual functions were compared between the 2 groups. RESULTS: Differences between both groups in age (72.56 ± 7.36 vs 71.98 ± 7.33) and IPSS score (18.65 ± 5.72 vs 20.50 ± 7.12) were not statistically significant (P >.05). Meanwhile, comparison in erectile function symptom score (14.80 ± 5.93 vs 7.35 ± 4.38) demonstrated significant differences (P <.001). According to the IIEF-5 score, 52 patients had normal erectile function or mild ED, 16 had moderate ED, and 12 had severe ED in the uncomplicated BPH group, whereas 10 patients had mild ED, 32 had moderate ED, 38 had severe ED, and no patients were found normal in BPH within the histological group. Further analysis using the chi-square test demonstrated significant differences between both groups (P <.001). CONCLUSION: BPH combined with histological prostatitis had a serious impact on sexual function of the patients. Histological prostatitis may serve as a major risk factor for sexual dysfunction while having little effects on LUTS in patients with BPH.

Long-term oncologic outcomes of laparoscopic versus open partial nephrectomy.

BACKGROUND: Most of the literatures on laparoscopic partial nephrectomy (LPN) versus open partial nephrectomy (OPN) focus on technical details and early or mid-term oncologic outcomes, reflecting that the approach is safe and provides midterm benefits compared with traditional open surgery. However, the difference of long-term oncologic outcome between LPN and OPN remains unclear. The aim of this meta-analysis was to evaluate the long-term oncologic outcome of LPN in the treatment of localized renal tumors compared with that of OPN. METHODS: A systematic search of electronic databases including Medline, Embase, and Cochrane library was conducted. Comparative studies reporting on long-term oncologic outcome of LPN versus OPN were regarded eligible. The odds ratio (OR) and its corresponding 95% confidence intervals (CI) were calculated for the oncologic outcomes. The methodologic quality of the included studies was evaluated using the strict criteria of the Newcastle-Ottawa scale. RESULTS: Six comparative studies (1495 participants including 555 LPN and 940 OPN) were included in the present study. There was no significant difference between LPN and OPN in 5-year overall survival (OS) rates (OR = 1.83, 95% CI (0.80, 4.19)), 5-year cancer specific survival (CSS) rates (OR = 1.09, 95% CI (0.62, 1.92)), and 5-year recurrence free survival (RFS) rates (OR = 0.68, 95% CI (0.37, 1.26)). CONCLUSION: The results of this meta-analysis revealed that there was no significant difference in long-term oncologic outcome between LPN and OPN for treatment of localized renal tumors.

Androgen-STAT3 activation may contribute to gender disparity in human simply renal cysts.

BACKGROUND: Simple renal cysts (SRC) are a common urological disease mostly in elderly, however the male-to-female ratio was 2.81. Androgen receptor (AR) activation was initially proposed as a vital signaling pathway in prostate cancer and consequent signal transducer and activator of transcription 3 (STAT3)-AR complex led an important putative mechanism by which prostate cells are sensitized with growth factor signals. However, in SRC disease, no related study emerged. METHODS: 30 patients with SRC and 20 age-matched healthy controls were recruited. Puncture biopsy was performed to acquire cyst-adjacent kidney tissue and normal kidney tissues were from healthy kidney donor who received living-related donor nephrectomy. The expression of STAT3 and androgen receptor was determined by immunohistochemical staining and western blotting. The in-vitro effect of androgen on human HK-2 (an immortalized proximal tubule epithelial cell line from normal adult human kidney) cells' STAT3 expression was analyzed as well. RESULTS: Activated STAT3 was strongly expressed in tubular epithelial cells from kidneys of SRC patients, while it was barely found in normal kidneys. Meanwhile, the androgen receptor positive cyst epithelial cells and adjacent normal renal tubule cells were observed in kidneys from SRC patients, however, AR was weakly expressed in normal healthy male kidneys, statistically significant differences existed. In-vitro experiment demonstrated that when treated with exogenous added androgen, the expression level of STAT3 in HK-2 cells was significantly elevated. CONCLUSIONS: Our data raised the possible novel evidence that androgen-STAT3 activation might contribute to gender disparity in human SRC disease and clarification the esoteric mechanisms will provide us attractive therapy target for cystic kidney disease.

Statin use and risk of bladder cancer: a meta-analysis.

PURPOSE: Emerging evidence suggests that statins may decrease the risk of cancers. However, available evidence on bladder cancer is conflicting. To quantify the association between statin use and risk of bladder cancer, we performed a detailed meta-analysis of published studies regarding this subject. METHODS: A literature search was carried out using MEDLINE, EMBASE, and OVID databases between January 1966 and October 2012. Before meta-analysis, between-study heterogeneity and publication bias were assessed using adequate statistical tests. Fixed- and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95 % confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses, sensitivity analysis, and cumulative meta-analysis were also performed. RESULTS: A total of 13 (three RCTs, five cohort, and five case-control) studies contributed to the analysis. There was heterogeneity among the studies, but no publication bias. Pooled results indicated a nonsignificant increase in total bladder cancer risk among all statin users [RR = 1.07, 95 % CI (0.95, 1.21)]. Long-term statin use did not significantly affect the risk of total bladder cancer [RR = 1.21, 95 % CI (0.92, 1.59)]. In our subgroup analyses, the results were not substantially affected by study design, region, and confounder adjustment. Furthermore, sensitivity analysis confirmed the stability of the results. CONCLUSIONS: The findings of this meta-analysis suggested that there was no association between statin use and risk of bladder cancer. More studies, especially RCTs, are needed to confirm this association.

A comparative study of thulium laser resection of the prostate and bipolar transurethral plasmakinetic prostatectomy for treating benign prostatic hyperplasia.

UNLABELLED: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Thulium laser is a new generation of surgical laser. It is a minimally invasive technology with several advantages, including rapid vaporization and minimal tissue damage and bleeding. However, details regarding the safety and efficacy of thulium laser in treating BPH remains unknown. We performed a comparative study in 100 patients with BPH of the safety and efficacy of thulium laser resection of the prostate (TMLRP, n = 50) and bipolar transurethral plasmakinetic prostatectomy (TUPKP, n = 50). We found that the efficacy and indications were the same in TMLRP and TUPKP. In TUPKP, the morbidity of urethrostenosis was low, and was nearly bloodless in surgery and had higher safety. Nevertheless, TUPKP is more suitable for patients with larger prostate volume. OBJECTIVE: To compare the safety and short-term efficacy of thulium laser resection of the prostate (TMLRP) and bipolar transurethral plasmakinetic prostatectomy (TUPKP) for the treatment of patients with benign prostatic hyperplasia (BPH). METHODS: A total of 100 patients diagnosed with BPH were randomly divided into two groups, treated with either TMLRP (50, group 1) or TUPKP (50, group 2). There was no significant difference in preoperative variables such as age, prostate volume, prostate-specific antigen (PSA) level, International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax ) and postvoid residual urine volume (PVR) between the two groups. The perioperative parameters and therapeutic effects were recorded and compared between the two groups. RESULTS: There were significant differences in the following parameters between the two groups (TMLRP vs TUPKP [mean ± SD]): operation duration, 61.2 ± 24.2 vs 30.14 ± 15.9 min; catheterization time, 1.8 ± 0.4 vs 3.2 ± 0.6 d; postoperative hospital stay, 3.3 ± 0.8 vs 4.1 ± 1.3 d. The volume of blood loss and postoperative bladder irrigation were significantly lower in TMLRP group than in the TUPKP group. At 1 month after the operation, there were four cases of urethral stricture in the TUPKP group. At 3 months after the operation, IPSS, quality of life (QoL), Qmax and PVR were significantly improved, with no significant difference between the two groups. CONCLUSIONS: TMLRP is superior to TUPKP in terms of safety, blood loss, recovery time and complication rate, and is as efficacious as TUPKP for treating BPH. Operation duration was significantly longer in the TMLRP group than in the TUPKP group.