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Diagnostics
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Diagnosis and Management of Urologic Disease
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Diagnosis and Management of Urologic Disease

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

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 10287

Special Issue Editor

Prof. Dr. Kehung Tsui

E-Mail Website
Guest Editor
Department of Urology, Chang Gung Memorial Hospital, 5 Fu-Shng street, Kweshan, Taoyuan 333, Taiwan
Interests: oncology; surgery; urology and nephrology; endocrinology

Special Issue Information

Dear Colleagues,

Geriatric urology is very common when treating very complicated diseases. Because of improvements in medical care, the average life expectancy of patients affected by urological diseases has increased considerably in recent decades; technical innovations, new drugs, and new surgical methods have all led to improvements. The aim of this Special Issue is to provide information on the current and potential use of precision medicine in geriatric urology. Geriatric urology encompasses a multifactorial clinical syndrome with an extremely complicated clinical course, and is very diverse with respect to clinical patterns. Early diagnosis is of crucial importance for the final clinical outcome. Previous studies have not identified a biomarker with sufficient sensitivity and specificity for the diagnosis of geriatric urologic disease. Identification of target agents and the use of clinically collected data have brought about significant benefits for patients in terms of early diagnosis. Therefore, we are currently collecting clinical data and molecular biomarkers using “omics” technologies, with sufficient diagnostic specificity and sensitivity to be able to predict the clinical course of the disease and patient response to therapy. All analyses consider the precise medicine and patient engagement practice in order to provide readers with a useful tool for everyday clinical practice. We hope to provide readers with an interesting tool for use in everyday clinical practice and invite urology experts to share their experiences.

Prof. Dr. Kehung Tsui
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate
  • urinary tract
  • bladder
  • neoplasm
  • surgery
  • biomarker
  • diagnostic
  • endoscopy

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Published Papers (3 papers)

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13 pages, 706 KiB  
Article
Treatment Strategy for Dialysis Patient with Urothelial Carcinoma
by Yun-Ching Huang, Yu-Liang Liu, Miao-Fen Chen, Chih-Shou Chen and Chun-Te Wu
Diagnostics 2021, 11(11), 1966; https://doi.org/10.3390/diagnostics11111966 - 22 Oct 2021
Cited by 5 | Viewed by 1573
Abstract
To investigate postoperative complications and oncologic outcomes of prophylactic nephroureterectomy and/or cystectomy in dialysis patients with urothelial carcinoma (UC), we retrospectively reviewed the records of dialysis patients with UC and a final status of complete urinary tract extirpation (CUTE, i.e., the removal of [...] Read more.
To investigate postoperative complications and oncologic outcomes of prophylactic nephroureterectomy and/or cystectomy in dialysis patients with urothelial carcinoma (UC), we retrospectively reviewed the records of dialysis patients with UC and a final status of complete urinary tract extirpation (CUTE, i.e., the removal of both kidneys, ureters, and bladder) between January 2004 and December 2015. Patients undergoing dialysis after initial radical nephroureterectomy and/or cystectomy were excluded. Eighty-four and 27 dialysis patients, undergoing one-stage and multi-stage CUTE, were enrolled in this study, respectively. Demographic, medical, perioperative, and pathologic features were collected to determine variables associated with oncologic outcomes. Although there was no significant difference in mortality between the 2 groups (p = 0.333), all 5 (4.5%) patients with Clavien–Dindo grade 5 complications were from the one-stage CUTE group. On multivariate logistic regression analysis, advanced age (p = 0.042) and high Charlson comorbidity index (CCI) (p = 0.000) were related to postoperative major complications. Compared with multi-stage CUTE, one-stage CUTE had no overall, cancer-specific, and recurrence-free survival benefits (all p > 0.05). According to multivariate analysis with Cox regression, age > 70 years (HR 2.70, 95% CI 1.2–6.12; p = 0.017), CCI ≥ 5 (HR 2.16, 95% CI 1.01–4.63; p = 0.048), and bladder cancer stage ≥ 3 (HR 12.4, 95% CI 1.82–84.7; p = 0.010) were independent, unfavorable prognostic factors for the overall survival. One-stage CUTE is not associated with superior oncologic outcomes, and all perioperative mortalities in our series occurred in the one-stage CUTE group. Our data do not support prophylactic nephroureterectomy and/or cystectomy for uremic patients with UC. Full article
(This article belongs to the Special Issue Diagnosis and Management of Urologic Disease)
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13 pages, 16390 KiB  
Article
An Automatic Bleeding-Rank System for Transurethral Resection of the Prostate Surgery Videos Using Machine Learning
by Jian-Wen Chen, Wan-Ju Lin, Chun-Yuan Lin, Che-Lun Hung, Chen-Pang Hou and Chuan-Yi Tang
Diagnostics 2021, 11(10), 1767; https://doi.org/10.3390/diagnostics11101767 - 26 Sep 2021
Cited by 4 | Viewed by 2070
Abstract
Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging males. Transurethral resection of the prostate (TURP) surgery is performed by a cystoscope passing through the urethra and scraping off the prostrate piece by piece through a [...] Read more.
Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging males. Transurethral resection of the prostate (TURP) surgery is performed by a cystoscope passing through the urethra and scraping off the prostrate piece by piece through a cutting loop. Although TURP is a minimally invasive procedure, bleeding is still the most common complication. Therefore, the evaluation, monitoring, and prevention of interop bleeding during TURP are very important issues. The main idea of this study is to rank bleeding levels during TURP surgery from videos. Generally, to judge bleeding level by human eyes from surgery videos is a difficult task, which requires sufficient experienced urologists. In this study, machine learning-based ranking algorithms are proposed to efficiently evaluate the ranking of blood levels. Based on the visual clarity of the surgical field, the four ranking of blood levels, including score 0: excellent; score 1: acceptable; score 2: slightly bad; and 3: bad, were identified by urologists who have sufficient experience in TURP surgery. The results of extensive experiments show that the revised accuracy can achieve 90, 89, 90, and 91%, respectively. Particularly, the results reveal that the proposed methods were capable of classifying the ranking of bleeding level accurately and efficiently reducing the burden of urologists. Full article
(This article belongs to the Special Issue Diagnosis and Management of Urologic Disease)
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13 pages, 3066 KiB  
Systematic Review
Spontaneous Bladder Rupture after Normal Vaginal Delivery: Description of a Rare Complication and Systematic Review of the Literature
by Guglielmo Stabile, Francesco Cracco, Davide De Santo, Giulia Zinicola, Federico Romano, Nicolò De Manzini, Serena Scomersi and Giuseppe Ricci
Diagnostics 2021, 11(10), 1885; https://doi.org/10.3390/diagnostics11101885 - 13 Oct 2021
Cited by 5 | Viewed by 5595
Abstract
Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm. Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published [...] Read more.
Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm. Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published from 1990 and only English articles were included. The research strategy adopted included the following terms: (bladder rupture) AND (spontaneous) AND (delivery). 103 studies were identified. Duplicates were found through an independent manual screening. Subsequently, two authors independently screened the full text of articles and excluded those not pertinent to the topic. Discrepancies were resolved by consensus. Finally, thirteen studies were included. Results: PRISMA guidelines were followed. For each study, fetal weight, catheterization during labor, parity, maternal age, occurrence time, previous abdominal or pelvic surgery, symptoms complained of, diagnostic methods, and treatment were considered. Median age was 26.0 (range 20–34 years); median presentation time was 3.0 days after delivery (range 1–20 days); and median newborn weight was 3227.0 g (range 2685–3600 g). Catheterization during labor was reported only in four of the thirteen cases (30.8%) identified. The symptoms most frequently complained of were abdominal pain and distension, fever, oliguria, haematuria and vomiting. Instrumental diagnosis was performed using X-rays in five cases and computerized tomography in six cases. Ultrasound was chosen in five cases as a first diagnostic tool. In two cases, cystography was performed. Treatment was always laparotomic repair of the visceral defect. Conclusion: Abdominal pain, increased creatinine and other signs of kidney failure on blood tests should lead to suspicion of this complication. Cystourethrography is regarded as a procedure of choice, but a first ultrasound approach is recommended. The main factor for the therapeutic choice is the intraperitoneal or extraperitoneal rupture of the bladder. Classical management for intraperitoneal rupture of the bladder is surgical repair and urinary rest. Full article
(This article belongs to the Special Issue Diagnosis and Management of Urologic Disease)
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