Is 3D Volumetric Evaluation Consistent with Postoperative Renal Parenchymal Preservation in Open and Robot-Assisted Laparoscopic Partial Nephrectomy?

Introduction: To evaluate by using 3D renal volumetric assessment and compare renal parenchymal preservation between patient who underwent open partial nephrectomy (OPN) and robot assisted laparoscopic partial nephrectomy (RALPN). Methods: We retrospectively reviewed the records of the patients to evaluate the effect of OPN (23 patients) or RALPN (19 patients) partial nephrectomy on renal parenchymal preservation. The CT or MRI were examined using 3D-Slicer image processing software. The tumor volume and preoperative and postoperative non-tumor bearing parenchymal volumes were evaluated with the segmentation. The preoperative and postoperative parenchymal volumes, serum creatinine levels, and estimated glomerular filtration rates (eGFRs) were compared between the surgical techniques. Results: The data of 42 patients were included in the final analysis. The patient and tumor characteristics were similar between the two groups. Postoperative renal parenchymal volumetric changes were seen similar between groups. Although the serum creatinine levels and eGFRs did not change postoperatively in the RALPN group (P = .145 and P = .085, respectively), creatinine increased while eGFR decreased in the OPN group (P = .003 and P = .002, respectively). Conclusions: Our analysis showed that RALPN could be considered similar to OPN in terms of parenchymal volume preservation, but the rate of parenchymal volume preservation was not associated with the change in functional parameters. These results should be supported by further research.

Are elevated mitochondrial DNA fragments in prostatic inflammation a potential biomarker for prostate cancer?

BACKGROUND: We sought to determine whether two soluble forms with different size of mtDNA are linked to prostatic inflammation, and whether they discriminate prostate cancer (PCa) from inflammatory prostatic conditions. METHODS: Histopathologically diagnosed prostatitis, PCa and benign prostatic hyperplasia patients (n = 93) were enrolled in this study and they were categorized as with and without prostate inflammation. Quantitative RT-PCR was used to analyze the levels of 79-bp and 230-bp fragments in urine and blood samples collected following prostate massage. RESULTS: The urine mtDNA-79 and mtDNA-230 were significantly increased in patients with prostate inflammation compared with those in without inflammation. Here, 79-bp fragment of apoptotic origin was significantly higher level than 230-bp fragment of necrotic origin. Although mtDNA-79 copy number in serum samples was also increased in patients with prostate inflammation, mtDNA-230 was similar in the two groups. Furthermore, mtDNA-79 and mtDNA-230 copy numbers in postprostate massage urine were higher (about 16-fold and 22-fold, respectively) than those from serum samples. ROC analysis showed that, although post-prostate massage urine have relatively higher performance than blood, ability to discriminate cases of both fragments was not better than that of serum total PSA. CONCLUSIONS: Our results demonstrate that shorter cf-mtDNA fragment size in particular, increase in the presence of prostate inflammation in post-prostatic massage urine but both fragments could never improve serum total PSA performance.

Urodynamic Curve Patterns may Predict Female Bladder Outlet Obstruction and Detrusor Underactivity.

OBJECTIVE: To search for independent predictors for distinguishing bladder outlet obstruction (BOO) and detrusor underactivity (DU) in female patients with voiding difficulty. MATERIALS AND METHODS: A retrospective patient file review was performed of 918 female patients with lower urinary tract symptoms. After exclusion criteria, 148 patients with voiding difficulty were eligible for the study. Patients were classified as having BOO and DU based on urodynamic BOO and DU definitions. The symptoms, patient characteristics, the patterns of free urine flow, and detrusor voiding pressure curves were compared between 2 groups. RESULTS: Of 148 patients with a median age of 53 (18-86), 42 (28,4%), 37 (25%), 69 (46,6%) patients had a urodynamic diagnosis of BOO, DU, and unclassified P/F study respectively. Multivariate logistic regression analysis results showed that the symptom of weak urine stream [P = .015 OR = 7.07 CI(1,47-34,0)], the negative provocative stress test [P = .038 OR = 7.32 CI(1,12-47,83)], the continuous detrusor voiding pressure and the prolonged/tailed shaped free urine flow curve patterns [P < .001 OR = 2,99 CI(1,66-5,38)] were the independent predictors of BOO. Sensitivity and specifity values for prolonged/tailed to predict BOO were 82.5 and 60% respectively. CONCLUSIONS: The continuous detrusor voiding pressure and the prolonged/tailed shaped free urine flow curve patterns were found to be useful independent predictors for distinguishing BOO from DU in female patients with voiding difficulty. In addition, the symptom of weak urine stream, and the negative provocative stress test may be of beneficial use.