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| EDITORIAL |
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| Year : 2022 | Volume
: 33
| Issue : 3 | Page : 99-100 |
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Editorial
Yao-Chi Chuang
Department of Urology, The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital; Department of Urology, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| Date of Submission | 21-Jul-2022 |
| Date of Acceptance | 21-Jul-2022 |
| Date of Web Publication | 25-Aug-2022 |
Correspondence Address:
Yao-Chi Chuang
Department of Urology, The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/UROS.UROS_81_22
How to cite this article:
Chuang YC. Editorial. Urol Sci 2022;33:99-100 |
In this issue, we publish two review articles: neurogenic voiding dysfunction in spinal cord injury (SCI) and the role of aromatase inhibitors (AIs) in treating hypogonadism and male infertility. In addition, we have selected the articles on urological oncology, minimally invasive treatment for donor nephrectomy (DN), tubeless minipercutaneous nephrolithotomy, bladder neck contracture (BNC), and prostate cancer. Moreover, the impact of COVID-19 on the competence of resident training in urology is worthy of awareness, and we publish about it in this issue. Finally, we hope that Urological Sciences make it easier for readers to stay up-to-date with the hot topics in urology.
The lower urinary tract (LUT) has two primary functions: the storage and voiding of urine, which are regulated by a complex neural control system. SCI impairs voluntary control of voiding and the normal reflex pathways that coordinate bladder and sphincter function. Wada and Yoshimura et al. have reviewed and summarized the recent advancement in LUT dysfunction in the sacral cord injury and discussed the potential targets for new treatments.
AIs are a reasonable treatment for infertile men with low testosterone levels and a low testosterone-to-estrogen ratio. Moreover, semen characteristics improve after AI treatment in patients with oligozoospermia. Huang reviewed the physiological action of aromatase and the indications of AI treatment in detail, mainly focusing on spermatogenesis in infertile men. Understanding the roles of AIs will benefit in treating hypogonadism and male infertility.
Prevention measures against the COVID-19 pandemic result in fewer opportunities for urology residents to learn. Wisda Kusuma et al. analyzed 147 urology residents across five urology education centers in Indonesia who responded to a self-administered online questionnaire about their objectives and subjective experience regarding urology residency before and during the COVID-19 pandemic. Among them, 57.82% of the participants awarded “being negative causes negative consequences.” Anxiety toward competence level was reported in 70.06% of participants. As the COVID--19 pandemic has lasted for more than 2 years, more attention should be paid to residents' competence levels while maintaining the COVID-19 prevention protocol.
Lu et al. investigated the risk of subsequent malignancies in patients with renal cell carcinoma (RCC) using the Cancer Registry Database of National Taiwan University Hospital (NTUH), National Health Insurance Research Database (NHIRD), and registry for catastrophic illness patients, a subset from NHIRD.
They found that 141 of 1188 (11.9%) patients with RCC treated at NTUH had subsequent malignancies. Cancers in the colon, liver, prostate, lung, and stomach were the five most common other primary malignancies. Moreover, the nationwide analysis showed that 4.68% of the RCC patients had subsequent malignancies. The percentage was significantly higher than that of the general population in Taiwan. RCC with subsequent malignancies is a multifactorial process, and the underlying mechanism remains to be elucidated.
BNC after endoscopic surgery for benign prostatic hyperplasia (BPH) often needs repeated surgical intervention. Abbosov et al. assessed the results of balloon dilation in patients with BNC after endoscopic surgery for BPH. They compared it with transurethral resection (TUR) of bladder neck plus alpha-blockers. The TUR of bladder neck plus repeated balloon dilation has a better outcome in relieving LUT symptoms and reducing the possibility of BNC recurrence.
Obesity has been proven to affect the outcomes of many surgical procedures. Tung et al. investigated the impact of obesity on the clinical outcomes after robot-assisted radical prostatectomy (RARP) by an experienced surgeon. They found that obesity and central obesity resulted in longer operation time and more blood loss in extraperitoneal RARP despite the same functional outcomes regardless of the obesity degree. As this is a small-scale and retrospective study, large-scale and prospective studies are necessary to elucidate the relationship between obesity and the outcome of RARP.
Laparoendoscopic single-site (LESS)-DN is an evolutionary minimally invasive surgery. Lin et al. present a retrospective analysis of a single-institution DN series comparing the transperitoneal (N = 8) to retroperitoneal (N = 9) LESS-DN regarding operative outcomes. They found that retroperitoneal LESS-DN showed similar perioperative outcomes as transperitoneal LESS-DN without compromising donor safety and providing a faster operation time, shorter length of stay, and a trend toward a shorter warm ischemia time. Both methods were safe and effective for living kidney transplantation by experienced surgeons.
Lee et al. compared the outcome and safety of tubeless mini-percutaneous nephrolithotomy (mini-PCNL, N = 74) and retrograde intrarenal surgery (RIRS, N = 66) for treating patients with renal and upper ureteral stones between 2 and 3 cm. Tubeless mini-PCNL offered a better immediate stone-free rate outcome than RIRS (78.4% vs. 36.4%, P < 0.001) and lower operation time, but with a longer hospital stay. However, 3month postoperative stone-free rate was no significant difference (78.4% vs. 68.2%, P = 0.172). Therefore, tubeless mini-PCNL and RIRS were safe and effective for medium-sized renal calculi.
We hope that you find these articles relevant in expanding your knowledge in urology.
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