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International Journal of Urology (2014) 21, 441
doi: 10.1111/iju.12417
IJU this issue
Tomohiko Ichikawa M.D., Ph.D. Associate Editor
T
his issue contains 13 Original Articles and one Japanese Urological Association Cancer Registration Statistics on upper urinary tract urothelial carcinoma. Nephrometry scores were originally developed to quantify the anatomical features of tumors, including the size and location, which were associated with technical difficulties and operative outcomes in nephron-sparing surgery. Maeda et al. (Nagoya, Japan) retrospectively assessed the utility of diameter–axis–polar nephrometry score to evaluate partial nephrectomy outcomes, and compared the diameter–axis–polar score with the R.E.N.A.L. score, which seems to be the most widely used so far. According to the univariate and multivariate analyses, they concluded that diameter–axis–polar nephrometry score was more strongly associated with postoperative renal functional changes and ischemic time in patients undergoing partial nephrectomy than was the R.E.N.A.L nephrometry score. The therapeutic benefit of regional lymphadenectomy (LND) for patients with urothelial carcinoma of the upper urinary tract (UCUT) remains controversial. Kondo et al. (Tokyo, Japan) have carried out a non-randomized prospective study to further examine the role of LND in UCUT. From January 2005 to September 2012, 77 patients undergoing nephroureterectomy and anatomical template-based lymphadenectomy for non-metastatic (cN0M0) UCUT were enrolled. The authors found that patients treated with template-based LND had significantly better survival than those treated without LND, especially for ≥pT2N0M0 renal pelvic tumors. Further prospective, randomized trials in a larger series of patients would be required to confirm the therapeutic benefit of template-based LND in UTUC patients. Prostate-specific antigen (PSA)-based screening is widely used for the early detection of prostate cancer. Kitagawa et al. (Kanazawa, Japan) examined the individual results of annual PSA-based population screening in Japan, and analyzed the clinical characteristics and PSA kinetics of prostate cancer detected in repeat screening. From 2000 to 2011, 19 620 men participated in this screening program, and a total of 59 019 screenings were carried out. The annual cancer detection rates in first examinees were not markedly different in continuous annual screening. The rates of patients with high PSA velocity and low PSA doubling time were significantly higher in unfavorable than favorable cancer patients in repeat screening. The authors have concluded that repeat population screening could contribute to early detection of prostate cancer, and it seems that PSA kinetics might predict the cancer characteristics in repeat screening. It is possible that urine alkalization therapy, which has been in use for patients in interstitial cystitis/bladder pain syndrome, can alleviate hypersensitive bladder syndrome symptoms including bladder pain by reducing the stimulation of bladder afferent C-fibers by hydrogen ions. Ueda et al. (Kyoto, Japan) investigated the efficacy of urine alkalization therapy using citrates in patients with increased urinary frequency. They found that the severity of the symptoms of urinary frequency and bladder/pelvic pain tended to increase when the acidity of urine was increased. The symptoms of the patients were improved by urine alkalization, especially for patients with pain. They concluded that urine alkalization therapy is likely to be effective in the treatment of hypersensitive bladder syndrome including interstitial cystitis/bladder pain syndrome. Several putative comorbidities have been associated with the increased prevalence of nocturia. However, none has been directly implicated as a causative factor. Kim et al. (Seoul, Korea) investigated the putative association between nocturia and decreased serum testosterone levels in 2180 men visiting the outpatient clinic from July 2011 to August 2012 for lower urinary tract symptoms. According to the data analyzed, nocturia was associated with a decrease in serum testosterone independent of aging or prostate volume. In conclusion, nocturia, especially nocturnal polyuria, is associated with decreased serum testosterone. Patients with low serum testosterone show increased nocturnal urine output.
Conflict of interest None declared.
© 2014 The Japanese Urological Association
441
International Journal of Urology (2014) 21, 441
doi: 10.1111/iju.12417
IJU this issue
Tomohiko Ichikawa M.D., Ph.D. Associate Editor
T
his issue contains 13 Original Articles and one Japanese Urological Association Cancer Registration Statistics on upper urinary tract urothelial carcinoma. Nephrometry scores were originally developed to quantify the anatomical features of tumors, including the size and location, which were associated with technical difficulties and operative outcomes in nephron-sparing surgery. Maeda et al. (Nagoya, Japan) retrospectively assessed the utility of diameter–axis–polar nephrometry score to evaluate partial nephrectomy outcomes, and compared the diameter–axis–polar score with the R.E.N.A.L. score, which seems to be the most widely used so far. According to the univariate and multivariate analyses, they concluded that diameter–axis–polar nephrometry score was more strongly associated with postoperative renal functional changes and ischemic time in patients undergoing partial nephrectomy than was the R.E.N.A.L nephrometry score. The therapeutic benefit of regional lymphadenectomy (LND) for patients with urothelial carcinoma of the upper urinary tract (UCUT) remains controversial. Kondo et al. (Tokyo, Japan) have carried out a non-randomized prospective study to further examine the role of LND in UCUT. From January 2005 to September 2012, 77 patients undergoing nephroureterectomy and anatomical template-based lymphadenectomy for non-metastatic (cN0M0) UCUT were enrolled. The authors found that patients treated with template-based LND had significantly better survival than those treated without LND, especially for ≥pT2N0M0 renal pelvic tumors. Further prospective, randomized trials in a larger series of patients would be required to confirm the therapeutic benefit of template-based LND in UTUC patients. Prostate-specific antigen (PSA)-based screening is widely used for the early detection of prostate cancer. Kitagawa et al. (Kanazawa, Japan) examined the individual results of annual PSA-based population screening in Japan, and analyzed the clinical characteristics and PSA kinetics of prostate cancer detected in repeat screening. From 2000 to 2011, 19 620 men participated in this screening program, and a total of 59 019 screenings were carried out. The annual cancer detection rates in first examinees were not markedly different in continuous annual screening. The rates of patients with high PSA velocity and low PSA doubling time were significantly higher in unfavorable than favorable cancer patients in repeat screening. The authors have concluded that repeat population screening could contribute to early detection of prostate cancer, and it seems that PSA kinetics might predict the cancer characteristics in repeat screening. It is possible that urine alkalization therapy, which has been in use for patients in interstitial cystitis/bladder pain syndrome, can alleviate hypersensitive bladder syndrome symptoms including bladder pain by reducing the stimulation of bladder afferent C-fibers by hydrogen ions. Ueda et al. (Kyoto, Japan) investigated the efficacy of urine alkalization therapy using citrates in patients with increased urinary frequency. They found that the severity of the symptoms of urinary frequency and bladder/pelvic pain tended to increase when the acidity of urine was increased. The symptoms of the patients were improved by urine alkalization, especially for patients with pain. They concluded that urine alkalization therapy is likely to be effective in the treatment of hypersensitive bladder syndrome including interstitial cystitis/bladder pain syndrome. Several putative comorbidities have been associated with the increased prevalence of nocturia. However, none has been directly implicated as a causative factor. Kim et al. (Seoul, Korea) investigated the putative association between nocturia and decreased serum testosterone levels in 2180 men visiting the outpatient clinic from July 2011 to August 2012 for lower urinary tract symptoms. According to the data analyzed, nocturia was associated with a decrease in serum testosterone independent of aging or prostate volume. In conclusion, nocturia, especially nocturnal polyuria, is associated with decreased serum testosterone. Patients with low serum testosterone show increased nocturnal urine output.
Conflict of interest None declared.
© 2014 The Japanese Urological Association
441
