Outcome of a 980-nm diode laser coagulation in women with radiation-induced hemorrhagic cystitis: a single-center retrospective study.

The purpose of this study was to evaluate the efficacy of a 980-nm diode laser coagulation in women with radiation-induced hemorrhagic cystitis (RHC). We conducted a retrospective study of 21 RHC patients treated with a 980-nm diode laser between July 2014 and December 2017 at our institution. Data was collected with regard to age, sex, lower urinary tract symptoms, use of transfusions, a drop in hemoglobin levels, indication of radiotherapy, median time between radiation therapy and presentation, previous treatments, operative time, mean energy used, number of coagulated areas, catheterization time, discharge time after treatment, hospital stay, and surgical outcome. All 21 patients were women with a median age of 52 years (range 36-68 years). Eighteen patients complained of frequency and urgency, four patients had dysuria, and one patient developed urinary retention. Radiation therapy was primarily indicated in the treatment of cervical cancer in 18 patients (85.7%) and endometrial cancer in three patients (14.3%). Nine patients (42.8%) received blood transfusion before surgery and three patients (14.3%) needed blood transfusion after the procedure. The mean decrease in hemoglobin prior to the procedure was 4.08 ± 2.04 g/dL. The median length of time from completion of radiotherapy to the presentation of hematuria was 38 months (range 8-65 months). All patients had failed an adequate trial of conservative treatment which included adequate hydration, hemostatics, continuous bladder irrigation (CBI), and clot evacuation at the bedside. Eleven patients (52.4%) had previously been treated with endoscopic electrocoagulation; the mean number of procedures was 1.73 ± 0.78 (range 1-3 sessions). Six patients (28.6%) underwent HBO, and sodium hyaluronate solution irrigation was administered to 3 patients (14.3%). The mean number of HBO sessions was 26.3 ± 16.8 (range 8-50), and the mean number of sodium hyaluronate solution irrigation procedures was 4.33 ± 1.53 (range 3-6). All operations were successful. The mean operative time was 45.6 ± 12.3 min, the mean number of coagulated areas was 11.7 ± 4.4, the mean energy used was 2.74 ± 1.14 kJ, the mean catheterization time was 6.2 ± 0.9 days, the mean discharge time after treatment was 6.8 ± 1.2 days, and the average length of a hospital stay was 7.4 ± 1.3 days. In 16 patients (76.2%), hematuria was completely resolved after one session of diode laser coagulation. Four patients (19.0%) underwent multiple sessions of laser treatment due to recurrent gross hematuria (three patients required two sessions and one patient required three sessions). Only one patient (4.8%) who had persistent gross hematuria after diode laser treatment (two sessions) underwent a radical cystectomy, which resolved the hematuria. The median hematuria-free interval of patients who had multiple procedures was 9 months (range 1-13 months). In total, 21 patients underwent 27 sessions of diode laser coagulation, and the median hematuria-free interval was 16 months (range 1-45 months) with a median follow-up of 25 months (range 7-48 months). Our study shows promising results for the management of patients with RHC; however, further evaluation with a larger cohort is required to confirm the efficacy of this treatment.

Kinesin family member 23 (KIF23) contributes to the progression of bladder cancer cells in vitro and in vivo.

The aim of our study was to detect the expression of KIF23 in human bladder cancer tissues and to assess the potential role of KIF23 in bladder cancer progression. The expression of KIF23 and the correlation with bladder cancer patients were explored using the TCGA database. Additionally, IHC assays were also performed to detect KIF23 expression in 95 bladder cancer tissues and corresponding non-tumor tissues collected in our hospital. Colony formation, MTT, and flow cytometry (FCM) assays were performed to detect its effects on bladder cancer cell proliferation and apoptosis, respectively. An animal model was developed to found the effects of KIF23 on tumor growth in mice. Data showed that the KIF23 expression was upregulated in human bladder cancer tissues. The expression of KIF23 was correlated with the prognosis and clinicopathological features, including T stage (p=0.022) and recurrence (p=0.020), of bladder cancer patients. KIF23 depletion inhibited the proliferation of bladder cancer cells, stimulated apoptosis, and suppressed tumor growth in mice. We demonstrated the involvement of KIF23 in bladder cancer progression and provided a promising therapeutic target for the treatment of bladder cancer.

Adenylate kinase 4 promotes bladder cancer cell proliferation and invasion.

Bladder cancer is the second most common urological cancer worldwide with low early diagnosis and high mortality. Since the time of diagnosis directly affects survival rate, early detection and precise biomarkers of bladder cancer are very important. Adenylate kinase 4 (AK4) is a key enzyme involved in cellular metabolism and multiple cancer development; however, the potential role of AK4 in bladder tumorigenesis is still unclear. Immunohistochemistry assay was conducted to evaluate the expression level of AK4 in 107 human bladder cancer tissues. Overall survival and recurrence-free survival were used to assess the prognosis of patients. Colony formation and MTT assays [3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide] were performed to measure the proliferation capacity of tumor cells. Cell scratch assays and transwell assays were performed to measure the invasion capacity of tumor cells. The expression level of involved genes was measured by reverse transcription-polymerase chain reaction and western blot assays. The animal model was used to examine the effects of indicated protein on tumorigenesis and invasion in vivo. Herein, our study demonstrated that increased AK4 expression in patients with bladder cancer was associated with a poor prognosis. We further found that inhibition of AK4 in bladder cancer cell line T24 and 5637 can obviously inhibit the proliferation of cancer cells. Transwell assay results showed that down-regulated AK4 was related to the decreased metastasis of T24 and 5637 cells. In addition, AK4-shRNA transfected obviously inhibited tumor growth and metastasis in mice compared with the scramble group. Taken together, the results provide strong evidence of the involvement of AK4 in the progression of bladder cancer and suggest that it could have high potential as a therapeutic target of disease.

[Transurethral diode laser enucleation versus transurethral electrovaporization resection of the prostate for benign prostatic hyperplasia with different prostate volumes].

OBJECTIVE: To compare the clinical effect of diode laser enucleation of the prostate (DIOD) with that of transurethral resection of the prostate (TURP) on benign prostate hyperplasia (BPH) with different prostate volumes. METHODS: This retrospective study included 256 BPH patients treated by DIOD (n = 141) or TURP (n = 115) from March 2012 to August 2015. According to the prostate volume, we divided the patients into three groups: <60 ml (42 for DIOD and 31 for TURP), 60－80 ml (51 for DIOD and 45 for TURP), and >80 ml (48 for DIOD and 39 for TURP). We obtained the relevant data from the patients before, during and at 6 months after surgery, and compared the two surgical strategies in operation time, perioperative levels of hemoglobin and sodium ion, post-operative urethral catheterization time and bladder irrigation time, pre- and post-operative serum PSA levels, International Prostate Symptoms Score (IPSS), post-void residual urine (PVR) volume and maximum urinary flow rate (Qmax), and incidence of post-operative complications among different groups. RESULTS: In the <60 ml group, there were no remarkable differences in the peri- and post-operative parameters between the two surgical strategies. In the 60－80 ml group, DIOD exhibited a significant superiority over TURP in the perioperative levels of hemoglobin (ï¼»3.25 ± 1.53ï¼½ g/L vs ï¼»4.77 ± 1.67ï¼½ g/L, P <0.05) and Na+ (ï¼»3.58 ± 1.27ï¼½mmol/L vs ï¼»9.67 ± 2.67ï¼½ mmol/L, P <0.01), bladder irrigation time (ï¼»30.06 ± 6.22ï¼½h vs ï¼»58.32 ± 10.25ï¼½ h, P <0.01), and urethral catheterization time (ï¼»47.61 ± 13.55ï¼½ h vs ï¼»68.01 ± 9.69ï¼½ h, P <0.01), but a more significant decline than the latter in the postoperative PSA level (ï¼»2.34 ± 1.29ï¼½ ng/ml vs ï¼»1.09 ± 0.72ï¼½ ng/ml, P <0.05), and similar decline was also seen in the >80 ml group (ï¼»3.35 ± 1.39ï¼½ ng/ml vs ï¼»1.76 ± 0.91ï¼½ ng/ml, P <0.05). No blood transfusion was necessitated and nor postoperative transurethral resection syndrome or urethral stricture observed in DIOD. However, the incidence rate of postoperative pseudo-urinary incontinence was significantly higher in the DIOD (22.7%, 32/141) than in the TURP group (7.83%, 9/115) (P <0.05). CONCLUSIONS: DIOD, with its obvious advantages of less blood loss, higher safety, faster recovery, and more definite short-term effectiveness, is better than TURP in the treatment of BPH with medium or large prostate volume and similar to the latter with small prostate volume.

Metanephric adenofibroma in a 10-year-old boy: report of a case and review of the literature.

We reported a case of metanephric adenofibroma in a 10-year-old boy to describe the clinical, radiologic, and pathologic features and discuss its treatment and differential diagnosis. Nephrectomy was performed for the patient; final histopathologic evaluation was that of a metanephric adenofibroma. Epithelial and stromal elements were both positive for WT-1, Vimentin, PAX2, and the epithelial tumor cells were also positive for S100, AE1/AE3, PAX8, CK8/18, EMA and a few cells were positive for CK7. Larger vessel wall components were positive for SMA, Des, caldesmon while capillary components were positive for CD10, CD31, and CD34. CA-9, α-inhibin and CD-56 were negative in the neoplasm. The Ki-67 labeling index was <1%. Metanephric adenofibroma is a rare benign renal tumor; the diagnosis of it relies on pathology and immunohistochemistry. As its rarity, there is no standard treatment for this disease. The majority of patients underwent nephrectomy and had good prognosis, as it is a benign neoplasm.

A giant ureteral polyp mimicking as a bladder mass resected ureteroscopically by diode laser: a case report and literature review.

We presented a rare case with giant ureteral polyp that mimics bladder tumor in adult women, originating from the middle segment of the left ureter. The patient was a 42-year-old woman, with a 2.1×1.3 cm bladder mass detected incidentally on a health screening ultrasound. Computerized tomography (CT) of the pelvis revealed a solid tumor situated near to trigon. Cystoscopy demonstrated a tumor that periodically prolapsed into the bladder. After the tumor was identified as a ureteral polyp by ureteroscopy, an ureteroscopic resection by diode laser was performed. The tumor measured 9.0×0.5 cm, and the final pathological diagnosis was ureteral fibroepithelial polyp. No recurrence was observed at the 5-month follow-up.