Soc. Int. Urol. J., Volume 5, Issue 4 (August 2024) – 10 articles

Background/Objectives: Uric acid stones are the second most common type of kidney stones worldwide. Despite being cost-effective and widely available, pharmacological management for these stones is less utilized compared to surgical approaches. Therefore, we conducted a systematic review of the literature to assess the efficacy and shortcomings of oral dissolution therapy for uric acid stones. Methods: Embase, Scopus, PubMed, and Cochrane library databases were searched for English language studies on adults who were diagnosed with uric acid kidney stones and treated with oral dissolution therapy. Results: Twelve studies met our inclusion criteria. Potassium citrate was the primary agent used for dissolution in 10 of the studies and demonstrated a 50% or higher success rate for complete dissolution of uric acid stones. Treatment time for successful dissolution varied, with an average of 3 months minimum and an average of 2.78 years maximum. Overall, 11 of the studies recommended that oral dissolution therapy should be used for either treatment or prevention of uric acid stones. Conclusions: The available evidence demonstrates benefit of oral dissolution therapy for patients with uric acid stones. However, future rigorous studies are required to determine the optimal treatment regimen. Full article

Given its known prognostic role, we aimed to investigate the role of neutrophil–lymphocyte ratio (NLR) as a biomarker in metastatic castration-resistant prostate cancer (mCRPC) patients receiving ADT, either as monotherapy or in conjunction with abiraterone acetate (AA) and prednisone. This retrospective cohort study analyzed the LATITUDE study of men with high-risk mCSPC. Patients were assigned to receive either AA, prednisone, and androgen deprivation therapy (ADT) or placebo plus ADT. Using a previously established NLR threshold of 2.5, we evaluated if this could predict clinical response to abiraterone. At baseline, there were no significant differences in NLR values between the treatment groups. Of the known baseline prognostic factors, NLR was associated with albumin levels and Eastern Cooperative Oncology Group performance scores. Moreover, the number of bone metastases was higher in patients with NLR ≥ 2.5. On multivariable analysis, baseline NLR ≥ 2.5 did not predict overall survival, PSA progression-free, or metastasis-free survival. However, changes in PSA and NLR at six months indicated distinct survival patterns between the placebo and AA groups, suggesting the potential for their combined assessment as a prognostic tool. Baseline NLR was not an independent predictor factor for response to AA in the LATITUDE study, though NLR changes at 6 months may predict better survival beyond PSA values alone. Further research is required to better understand in which patients with advanced prostate cancer NLR changes may be a useful prognostic tool. Full article

Cystic hydatid disease is an endemic disease caused by the larval form of Echinococcus granulosis. It is especially evident in the liver, lungs, and kidney. Testicular hydatidosis is extremely rare. A case of a hydatid cyst of the testis is reported that was misdiagnosed clinically as a testicular hydrocele. Echinococcosis should be considered in the differential diagnosis of testicular masses especially in endemic countries. Treatment is mainly surgical and, with proper diagnosis and treatment, the prognosis is good. Full article

Objectives: There is currently limited local and international literature on the characteristics of uro-oncology multi-disciplinary team meetings (MDTMs) and their impact on clinical decision making. The aims of this study were to provide a comprehensive descriptive analysis of MDTMs at an Australian tertiary hospital over a 12-month period and their impacts on patient management, and to evaluate adherence to MDTM plans. Methods: We conducted a review of a prospectively maintained database of all uro-oncology MDTMs held within the Northern Adelaide Local Health Network (NALHN) over a 12-month period in 2020–2021. Results: During this 12-month period, 24 MDT meetings were conducted, in which 280 patients were discussed. Overall, MDTMs resulted in modifications to the management of 25.7% of patients, which was consistent across all three major tumour streams (24% for prostate cancer, 29% for renal cell carcinoma, and 22% for urothelial carcinoma). MDTMs also facilitated cross referrals between specialties for 105 patients (37.5%), including 5 patients who were considered for entry into clinical trials. There was a high acceptance rate, with adherence to MDT recommendations for 270 of the 278 patients discussed (96.4%). MDTM plans were fully implemented within a 6-month period. Conclusions: We provided a detailed analysis of uro-oncology MDTMs at an Australian tertiary referral centre, demonstrating that MDTMs facilitate optimal cancer management for patients with urological cancers. Full article

Introduction and Objectives: In the modern context, where fertility is crucial for couples, male factors contribute 40–50% to subfertility. Testicular cancer survivors facing subfertility due to treatments like orchidectomy and chemotherapy can benefit from sperm banking. However, awareness is lacking, especially in culturally sensitive Asian populations where sex and fertility discussions are taboo. This study aims to assess attitudes and utilization of sperm banking, evaluate its impact on pregnancy outcomes, and identify implementation obstacles. Materials and Methods: A phone interview survey targeted testicular cancer patients treated at Hospital Sultanah Aminah Johor Bahru and Sarawak General Hospital in Malaysia (2019–2023). Of the 102 identified patients, 62 participated. Investigators, using contact details from medical records, conducted interviews with a blend of quantitative and qualitative inquiries. Bivariate analysis identified factors linked to the decision to pursue sperm banking. Results: Out of 62 participants, 58.1% were aware of sperm banking, yet 90.3% chose not to utilize it. Reasons for declining included physician non-offer (41.1%), cost concerns (21.4%), a desire for prompt treatment (16.1%), lack of interest (14.3%), and other factors (7.1%). Among six patients opting for sperm banking, 50% utilized banked sperm, resulting in successful progeny for two-thirds. Notably, one case led to multiple pregnancies. Ethnicity (p = 0.046) and religion (p = 0.026) significantly influenced decisions, with Muslim Malays being the least likely to utilize sperm banking. Conclusion: Sperm banking emerges as a cost-effective strategy for safeguarding fertility in testicular cancer patients. Healthcare providers should proactively offer this option before treatment, ensuring patients are well-informed and addressing concerns to foster informed decisions. Full article