Bladder cancer (BC) ranks as the sixth most prevalent cancer in the world, with a steady rise in its incidence and prevalence, and is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type. Diagnosis and monitoring of BC is mainly performed by invasive tests, namely periodic cystoscopies; this procedure, although a reliable method, is highly uncomfortable for the patient and it is not exempt of comorbidities. Currently, there is no formal indication for the use of molecular biomarkers in clinical practice, even though there are several tests available. There is an imperative need for a clinical non-invasive testing for early detection, disease monitoring, and treatment response in BC. In this review, we aim to assess and compare different tests based on molecular biomarkers and evaluate their potential role as new molecules for bladder cancer diagnosis, follow-up, and treatment response monitoring.
Background: Ureteral stents are one of the most used devices in Urology, allowing drainage of the upper urinary system, and can be used either in elective or emergency procedures. However, as a foreign body inside the urinary system, they are subject to encrustation. Encrustation is one of the burdens seen with double-J stents and, to date, there is no consensus about its best management. This study aims to prove that Endoscopic Combined Intra-Renal Surgery (ECIRS) is the best choice when there’s an encrusted proximal loop of a ureteral stent. Methods: The authors conducted a retrospective cohort study of patients with an encrusted proximal loop of the ureteral stent who underwent surgery at a single center, comparing ECIRS with other procedures. Results: Between July 2011 and June of 2024, 33 patients (18 females and 15 males) were submitted to surgery. The median indwelling time of the stent was 11 (8-19) months and a stentfree rate of 100% was achieved. The authors demonstrated a significant stone-free rate of 61.1% following ECIRS compared to merely 20% with other procedures (p = 0.023). Notably, while the complication rate was low across all procedures, the ECIRS group exhibited fewer complications (5.6%) than those undergoing alternate techniques (13.3%), though this difference was not statistically significant (p = 0.439). Conclusions: Our study advocates for ECIRS as the preferred initial treatment for encrusted proximal ureteral stents, as it facilitates superior stone clearance, minimizes complications, and maintains comparable operative efficiency. This research contributes valuable insights into the management of challenging cases involving encrusted ureteral stents, calling for future studies to further validate these findings.
Purpose: Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS).Materials and methods: Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented.Results: Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points.Conclusions: The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.