Challenges in Urology: From the Diagnosis to the Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 4175

Special Issue Editors


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Guest Editor
1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
2. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
Interests: urologic oncology; bladder cancer; kidney cancer; prostate cancer; epidemiology
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Guest Editor
Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
Interests: prostate cancer

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Guest Editor
Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
Interests: social media; immunology; medicine; scientific research
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
Interests: urologic oncology; bladder cancer; kidney cancer; prostate cancer; testis cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce this Special Issue addressing the challenges encountered in the field of urology. Urological conditions present a myriad of complexities, ranging from benign disorders to life-threatening malignancies, necessitating innovative approaches to diagnosis and management.

This Special Issue aims to bring together a collection of articles that shed light on the various challenges faced by urologists worldwide. From the complexities of surgical interventions to the intricacies of medical management, we seek to explore the multifaceted nature of urological challenges and the strategies employed to overcome them.

We invite researchers, clinicians, and experts in the field to contribute original research papers, review articles, and case studies that delve into the diverse challenges encountered in urology. Whether it be navigating the complexities of robotic surgery, addressing the rising incidence of urinary tract infections, or grappling with the psychological impact of urological disorders, we welcome contributions that provide insights and solutions to these challenges.

By fostering collaboration and sharing experiences, we aim to advance the field of urology and improve patient outcomes. Your contributions will play a pivotal role in shaping this special edition into a comprehensive resource for urologists worldwide.

We eagerly anticipate your submissions and look forward to working together to address the challenges in urology.

Dr. Simone Morra
Dr. Claudia Collà Ruvolo
Dr. Gianluigi Califano
Dr. Francesco Di Bello
Guest Editors

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Keywords

  • challenges
  • complications
  • rare
  • surgery
  • cancer

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Published Papers (3 papers)

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Research

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16 pages, 7207 KiB  
Article
Real-Time Dosimetry in Endourology: Tracking Staff Radiation Risks
by Susanne Deininger, Olaf Nairz, Anna Maria Dieplinger, Christian Deininger, Lukas Lusuardi, Christian Ramesmayer, Julia Peters, David Oswald, Maximilian Pallauf, Sophina Bauer, Mathias Christoph Brandt and Peter Törzsök
Diagnostics 2024, 14(16), 1763; https://doi.org/10.3390/diagnostics14161763 - 13 Aug 2024
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Abstract
Background: To retrospectively investigate scatter radiation (SCR) exposure among staff in the endourology operating theatre. Methods: During surgeries under fluoroscopic guidance, five professional groups (urological surgeon [US], surgical nurse [SN], assistant surgical nurse [ASN], anaesthetist [A], and anaesthesia care [AC]) wore real-time dosimeters [...] Read more.
Background: To retrospectively investigate scatter radiation (SCR) exposure among staff in the endourology operating theatre. Methods: During surgeries under fluoroscopic guidance, five professional groups (urological surgeon [US], surgical nurse [SN], assistant surgical nurse [ASN], anaesthetist [A], and anaesthesia care [AC]) wore real-time dosimeters (Philips DoseAware System) on their head and chest over lead aprons between July 2023 and February 2024. The SCR data were analysed and correlated with procedural and patient factors. Results: In total, 249 procedures were performed, including 86 retrograde intrarenal surgeries and 10 percutaneous nephrolithotomies. Median SCR exposure was 38.81, 17.20, 7.71, 11.58, 0.63, 0.23, 0.12, and 0.15 Microsievert (µSv) for US chest (USC), US head (USH), SN chest (SNC), SN head (SNH), A chest (AC), AC chest (ACC), ASN chest (ASNC), and ASN head (ASNH), respectively. There was a significant correlation between DAP and SCR doses detected by USC, USH, SNC, SNH, AC, and ACC dosimeters (p < 0.05). The median chest-to-eye conversion factor (CECF) was 2.11 for the US and 0.71 for the SN. Conclusions: This study, using real-time dosimetry, is among the first to assess staff occupational SCR exposure in endourology. It highlights a substantial SCR exposure, indicating an occupational health hazard that warrants further investigation. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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9 pages, 400 KiB  
Article
Transition from Transrectal to Transperineal MRI-Fusion Prostate Biopsy Does Not Comprise Detection Rates of Clinically Significant Prostate Cancer at a Tertiary Care Center
by Benedikt Hoeh, Mike Wenzel, Clara Humke, Cristina Cano Garcia, Carolin Siech, Melissa Schneider, Carsten Lange, Miriam Traumann, Jens Köllermann, Felix Preisser, Felix K. H. Chun and Philipp Mandel
Diagnostics 2024, 14(11), 1184; https://doi.org/10.3390/diagnostics14111184 - 5 Jun 2024
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Abstract
Background: A remarkable paradigm shift has emerged regarding the preferred prostate biopsy approach, favoring the transperineal (TP) over the transrectal (TR) approach due to the reduced risk of severe urinary tract infections. However, its impact on the detection of clinically significant prostate cancer [...] Read more.
Background: A remarkable paradigm shift has emerged regarding the preferred prostate biopsy approach, favoring the transperineal (TP) over the transrectal (TR) approach due to the reduced risk of severe urinary tract infections. However, its impact on the detection of clinically significant prostate cancer (csPCa) remains unclear. Materials and methods: We relied on a prospectively maintained tertiary care database to identify patients who underwent either TP or TR prostate biopsy between 01/2014 and 12/2023. Of those, only patients with suspicious magnetic resonance imaging (MRI) PIRADS lesions (Likert-scale: 3,4,5) received MRI-targeted and systematic biopsies. Detection rates of csPCa (International Society of Urological Pathology [ISUP] ≥ 2) were compared between biopsy approach (TP vs. TR) according to index lesion. Subsequently, uni- and multivariable logistic regression models were applied to investigate the predictive status of the biopsy approach within each subcohort. Results: Of 2063 patients, 1118 (54%) underwent combined MRI-guided and systematic prostate biopsy and were included in the final cohort. Of those, 127 (11%) and 991 (89%) underwent TP vs. TR. CsPCa rates, regardless of differences in patients’ demographics and distribution of index PIRDAS lesions, did not differ statistically significantly and were 51 vs. 52%, respectively (p = 0.8). CsPCa detection rates for PIRDAS-3, PIRADS-4 and PIRADS-5 did not differ and were 24 vs. 23%, 48 vs. 51% and 72 vs. 76% for PIRADS-3, PIRADS-4 and PIRADS-5 subgroups for TP vs. TR, respectively (all p ≥ 0.9) Conclusions: The current results support the available data indicating that TP biopsy approach is comparable to transrectal biopsy approach regarding csPCa detection rates. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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8 pages, 1577 KiB  
Case Report
Arteriovenous Fistula: The Case of a Rare Complication after Minimal Percutaneous Nephrostomy and Brief Review
by Răzvan Alexandru Dănău, Răzvan-Cosmin Petca, Traian Vasile Constantin, Aida Petca, Gabriel Predoiu and Viorel Jinga
Diagnostics 2024, 14(11), 1121; https://doi.org/10.3390/diagnostics14111121 - 28 May 2024
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Abstract
Percutaneous renal surgery, although much less invasive than other procedures, is subject to several complications, which can occur at any time during the course of treatment, starting from the performance of the minimal nephrostomy procedure. We present an extremely rare vascular complication of [...] Read more.
Percutaneous renal surgery, although much less invasive than other procedures, is subject to several complications, which can occur at any time during the course of treatment, starting from the performance of the minimal nephrostomy procedure. We present an extremely rare vascular complication of percutaneous nephrostomy represented by arteriovenous fistula that occurred in a 24-year-old patient known to have right ureteropelvic junction obstruction operated with the absence of double-J catheter permeability and grade II-III hydronephrosis for which minimal percutaneous nephrostomy was urgently fitted. The arteriovenous fistula was resolved by supraselective artery embolization. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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