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Geriatric Effects of Surgery Oncology.
Background The aim of this study is to assess validity of the ETXY Multifunctional trainer (ProDelphus, Olinda, Pernambuco, Brazil), a bench-top dry-lab model for simulation of cystoscopy and intravesical injections of Botulinum Toxin A (BTX-A) injections, in terms of educational value, feasibility and acceptability as well as evaluating the use of fresh frozen cadavers for intravesical BTX-A injections. Methods Prospective study with novice trainees and urologists (n=58) trained by experts (n=14) in a 30-min hands-on training session in intravesical administration of BTX-A over 6 training sessions throughout one year. Outcome measures were demonstrated through distribution and analysis of evaluation surveys on a 5-point Likert scale. Results There were 56 participants (96.6%) believed that the model has a role in training for the procedure. Participants also reported the training being an important confidence-booster for performing BTX-A injections (mean 4.05/5) and useful for teaching procedural steps (mean 3.89). Experts highly rated the realism of the simulator especially in simulation of needle penetration (mean 3.98) and delivery (mean 4.03). Fresh frozen cadavers had a mean realism rating of 4.54 and participants affirmed that they should be routinely used for training and assessment (mean 3.92). Conclusions This study demonstrated face and content validity in addition to establishing the feasibility and acceptability of the ETXY Multifunctional model in the training of intravesical BTX-A administration. Additionally, the simulator demonstrated educational value and fresh frozen cadavers were shown to be the preferred simulation modality for this procedure. Further evaluation in randomised controlled studies is needed to demonstrate higher evidence quality. 2019 Translational Andrology and Urology. All rights reserved.Background To examine the effects of environmental polychlorinated biphenyls (PCBs) 153 exposure, an industrial plasticizer, on serum testosterone levels. Methods Using data collected from the 1999-2000 and 2001-2002 National Health and Nutrition Examination Survey (NHANES), we analyzed serum total testosterone and PCB153 levels, demographic data and comorbidities for men aged 18 years and older. Univariate and multivariate linear regression analysis was used to evaluate the association between total testosterone and serum PCB153. Results Five hundred and fifty-seven men met inclusion criteria. Median age was 45.7 [33.4-60.4] years old while median serum total testosterone and PCB153 levels were 479 [352.5-607] ng/dL and 0.20 [0.11-0.39] ng/g, respectively. Increasing age, higher body mass index (BMI), higher levels of serum PCB153, lower levels of activity and a history of diabetes mellitus and coronary heart disease were associated with decreasing serum testosterone levels on univariate linear regression. On multivariate linear regression, increasing age (estimate -6.29 ng/dL per year of life, P less then 0.001) and BMI (estimate -7.08 ng/dL per unit BMI, P less then 0.001) were associated with declining serum testosterone levels. While serum PCB153 levels were found to be negatively correlated with serum testosterone levels on univariate analysis (estimate -179.67, P less then 0.001), this association was not significant on the multivariable model (estimate -12.83, P=0.673). Conclusions In this population-based analysis, we report an association between a decrease in serum testosterone with increasing serum levels of PCB153. Identifying environmental factors for etiology of low testosterone and mechanisms for causation will be important to aid in strategies to increase testosterone naturally in men. find protocol 2019 Translational Andrology and Urology. link2 All rights reserved.Background A mild increase in testicular and epididymal temperatures in men, bulls and rams (pendulous scrotum) inhibits spermatogenesis and increases the percentage of sperm with an abnormal morphology. However, the stages of spermatogenesis that are most sensitive to a mild increase in testicular temperature in men are unknown. The aim of the present study was to explore the effects of a mild induced increase in testicular and epididymal temperature (i.e., testicular temperature maintained below the core body temperature) on sperm morphology in humans depending on the physiological time of spermatogenesis and epididymal transit. Methods Five healthy volunteers were enrolled in an experimental study in which testicular and epididymal temperatures were increased by maintaining the testes in a supra-scrotal position with a specially designed underwear worn 15±1 h a day for 120 consecutive days. Semen collection was scheduled on specific days depending on spermatogenic stages and epididymal transit. Results Sperm morphology and the multiple anomalies index (MAI) were analysed before, during and after heating. This mild induced increase in testicular and epididymal temperatures resulted in a significant rise in the percentage of morphologically abnormal spermatozoa on day 34 of heating, which remained elevated throughout the heating period and persisted until 45 days after cessation of heating. The MAI was significantly increased on day 20 throughout the heating period and persisted 45 days after cessation of heating. An increase in the percentage of anomalies in the sperm head, acrosome or tail occurred on days 34 and/or 45 of heating. Abnormal sperm morphology and MAI reverted to control values 73 days after cessation of heating. Conclusions A mild sustained increase in testicular and epididymal temperature in man leads morphological abnormalities in spermatozoa mainly due to an impairment of spermiogenesis and meiosis. 2019 Translational Andrology and Urology. All rights reserved.Background Studies regarding the prevalence and factors associated with severe pre-operative chronic kidney disease (CKD) in upper tract urinary carcinoma (UTUC) patients were rare due to the low prevalence of UTUC. We conducted the present study to investigate the prevalence, clinicopathological features, and prognosis in UTUC patients with severe preoperative CKD. Methods The study included 731 patients with UTUC treated with radical nephroureterectomy (RNU) in a large Chinese center. Estimated glomerular filtration rate (eGFR) was calculated by re-expressed Modification of Diet in Renal Disease (MDRD) formulas for the Chinese population. Severe preoperative CKD was defined as CKD stage 4-5 (eGFR less then 30 mL/min). Relationships of CKD stage 4-5 with clinicopathological characteristics, overall survival (OS), cancer-specific survival (CSS), contralateral recurrence-free survival and intravesical recurrence (IVR)-free survival were analyzed. link3 Results A total of 73 (10.0%) patients presented severe preoperpatients. UTUC patients with severe preoperative CKD possess worse OS and higher possibility of contralateral upper urinary tract recurrence. 2019 Translational Andrology and Urology. All rights reserved.Background Intracytoplasmic sperm injection (ICSI) is a popular treatment for male infertility due to obstructive azoospermia (OA). Testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA) are two common sperm retrieval approaches for ICSI among men with OA. However, the comparative efficacies of TESA and PESA have been debated for more than a decade and there has been no synthesis of the available evidence. This meta-analysis compared fertility outcomes between TESA and PESA among men with OA undergoing ICSI. Methods We searched Embase, PubMed, ScienceDirect, and Web of Science to identify studies comparing the effectiveness of TESA and PESA for ICSI. Study quality was assessed using the Newcastle-Ottawa scale. Data were pooled using a random-effects model. Outcomes were fertilization rate, implantation rate, pregnancy rate, and miscarriage rate. Results are expressed as odds ratio (OR) with 95% confidence intervals (CIs). Study heterogeneity was evaluated by the I-square (I2) statistic. Results Of 2,965 references retrieved, eight studies met eligibility criteria. These studies included 2,020 men receiving 2,060 ICSI cycles. The pooled results showed no significant differences in pregnancy and miscarriage rates between TESA and PESA groups, but TESA yielded a significantly higher implantation rate than PESA (OR =1.58, P=0.02, I2=24%). Conclusions TESA and PESA yielded similar pregnancy and miscarriage rates for couples receiving ICSI because of OA, but each demonstrated unique advantages and disadvantages. Further studies are required to evaluate safety outcomes and efficacy for specific clinical groups. 2019 Translational Andrology and Urology. All rights reserved.Background Calcifying nanoparticles (CNPs) has been associated with the occurrence and development of kidney stones, but the exact mechanism is not clear. This study aimed to establish a rat model of CNP-induced renal epithelial injury and assess the efficacy of tetracycline in preventing this injury. Methods Kidney stones from patients after percutaneous nephrolithotomy (PCNL) were collected to isolate and culture CNPs. Thirty Sprague-Dawley rats were divided into three groups the sham group (G1), the CNP group (G2), and the CNP + tetracycline group (G3). Rats in G2 and G3 were given an intravenous injection of CNPs via the tail vein, while rats in G1 were given saline. Meanwhile, rats in G3 were given tetracycline by gavage twice a day at a dose of 25 mg/kg. After 8 weeks, the 24-h urine of all rats was collected, and all rats were sacrificed to obtain blood and kidneys. Results The results revealed that in G2, activities of antioxidant enzymes such as superoxide dismutase and catalase were significantly lower than those in G1, while malondialdehyde activity in G2 was significantly higher than that in G1 and both of them were inhibited by tetracycline co-treatment in G3. CNPs significantly increased expression of inflammatory cytokines, including monocyte chemotactic protein 1 and interleukin 6, which were largely alleviated in G3. CNPs significantly increased TUNEL-positive cells and the apoptosis activity of Bcl2-associated X protein but decreased B-cell lymphoma-2 level compared with that in G1, and was limited by tetracycline co-treatment in G3. Furthermore, CNPs led to notable renal tubular epithelial cell damage, hyaline cast formation, desquamation, swelling, vacuolization in histology, all of which were alleviated by tetracycline. Conclusions Tetracycline can attenuate CNP-induced renal epithelial injury through suppression of inflammation, oxidative stress, and apoptosis. 2019 Translational Andrology and Urology. All rights reserved.Background Immune infiltration has an important impact on the development of clear cell renal cell carcinoma (ccRCC). This article aims to investigate the association between immune infiltration and the clinical features as well as prognosis of clear cell renal cell carcinoma. Methods Analyze the immune infiltration in ccRCC by applying ESTIMATE and CIBERSORT methods on basic of dataset in TCGA and GEO. And identify the kind of immune cell and genes that may play the central role. Results High Immune score and high property of T-regs are both significantly associated with the poor OS, high stage and more chances of metastases in ccRCC. CXCL-1, SAA1, PMCH, CCL-5 are all significantly negatively correlated to OS and positively correlated to stage and chance of metastases in ccRCC. High property of T-regs, CXCL-1 and SAA1 are also significantly associated with high Fuhrman grade while PMCH and CCL5 not. Conclusions Immune infiltration in RCC has a negative influence on ccRCC and T-regs may play a vital role in this process mediated by CXCL-1 or SSA1.
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