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| EDITORIAL |
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| Year : 2023 | Volume
: 34
| Issue : 3 | Page : 107-108 |
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Editorial
Shu-Pin Huang
Department of Urology, Kaohsiung Medical University and Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| Date of Submission | 24-Aug-2023 |
| Date of Acceptance | 24-Aug-2023 |
| Date of Web Publication | 28-Sep-2023 |
Correspondence Address:
Shu-Pin Huang
No. 100, Tzyou 1st Road, Sanmin, Kaohsiung 80756
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/UROS.UROS_78_23
How to cite this article:
Huang SP. Editorial. Urol Sci 2023;34:107-8 |
Dear Colleagues,
In this issue of Urological Science, there were seven articles covering several important and interesting topics in urology. Gholami et al. provided the latest updates on approaching small renal masses (SRMs) and various management modalities.[1] SRMs are defined as contrast-enhancing solid masses detected on abdominopelvic imaging, with a size of ≤4 cm. Through this minireview, we can know when to perform renal mass biopsies according to the suggestion of clinical guidelines and the protocol of active surveillance. This article also reviewed the advancement of thermal ablation: radiofrequency ablation, cryoablation, and microwave for SRMs and the trend of partial nephrectomy/nephron-sparing approaches. The inclusive Figure provides an invaluable reference tool for SRM management.
The other article investigated the effect of metformin on the survival of patients with upper tract urothelial carcinoma (UTUC) who had type 2 diabetes. Using the data from the registry of the Taiwan National Health Insurance database, they demonstrated that metformin the use of metformin before and after the diagnosis of UTUC decreased the all-cause mortality rate when compared to new users in univariate and multivariate analyses. This finding suggested that the favorable anticancer role of metformin in localized UTUC and continuous metformin usage improves all-cause mortality in patients with localized UTUC and type 2 diabetes mellitus.
Cheriyan et al. from India reported the clinicopathological profile and outcomes of the rare collecting duct carcinoma of the kidney that often presents at an advanced stage and has a poor prognosis.[2] The findings of an analysis of 18 cases showed that the survival rate remains low despite surgery and adjuvant therapy.
Sakineh Hajebrahim's group calls the attention of readers to the field of functional urology: urinary incontinence, neurogenic bladder, overactive bladder, and lower urinary tract symptoms. They discern that many recommendations in this arena lack a foundation in systematic reviews, meta-analyses of randomized controlled trials (RCTs), or high-quality RCTs. This necessitates a more cautious approach to decision-making based on the recommendation grade and certainty.
One interesting article focuses on the survival rate and clinical characteristics of testicular tumors in patients with a history of scrotal violation. For suspected testicular cancer, radical inguinal orchiectomy is advised. Inguinal orchiectomy allows the surgeon to perform early ligation of the vessels and prevents tumor spillage. Scrotal violation means an intentional transscrotal orchiectomy, a testicular mass biopsy, or scrotal exploration that results in an incidental diagnosis of a testicular tumor. These findings showed that the survival rate of patients with testicular tumors who had a history of scrotal violation was lower and influenced by the Eastern Cooperative Oncology Group performance Status Scale. A scrotal breach in the last stage may be associated with a higher mortality rate.
The Taiwan Continence Society Spinal Cord Injury Study Group reported the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction among chronic spinal cord injured patients in Taiwan. They emphasized the pivotal role of urodynamic findings over neurogenic evaluations, urging the identification of high-risk patients to avert a decline in renal function. They stressed regular urodynamic assessments and the timely management of complications, with a preference for minimally invasive and reversible procedures when surgery is necessary.
Finally, a team from India presented their “Rule of Five” ureteral dilatation techniques during retrograde intrarenal surgery. This innovative method entails five iterations of ureteral dilatation using a 10 Fr ureteral dilator, each lasting 5 s. Their conclusion indicates that this technique facilitates the safe and successful placement of a ureteral access sheath in patients undergoing sequential ureteral dilatation.
We hope that these articles have enriched your knowledge and are helpful for practice.
Data availability statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
| References | |  |
| 1. | Gholami M, Kaouk J, Zargar H. Small renal masses. Urol Sci 2023;34:117-23.  [Full text] |
| 2. | Cheriyan A, Mukha RP, Balakumar S, John NT, Kumar S. Collecting duct carcinoma of the kidney: Clinicopathological profile and outcomes. Urol Sci 0;0:0. |
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