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EDITORIAL
Year : 2022 | Volume
: 33
| Issue : 1 | Page : 1-2
Step into 2022 with best luck
Yao-Chi Chuang
Editor-in-Chief, Department of Urology, The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital; College of Medicine, Chang Gung University, Kaohsiung, Taiwan
Correspondence Address:
Prof. Yao-Chi Chuang
Department of Urology, The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
Taiwan
Source of Support: None, Conflict of Interest: None
DOI: 10.4103/UROS.UROS_10_22
Dear Colleagues,
Many problems occur in our lives due to the effects of coronavirus disease 2019 (COVID-19). Several modifications have been made to adapt to the COVID pandemic, and current clinical practice and residency training differ compared to before the pandemic. Regardless of the challenges we faced, numerous researchers contributed to the first issue of Urological Science in 2022.
Recently, there has been a surge in the application of low-intensity extracorporeal shockwave therapy (Li-ESWT) for urological diseases. Wang et al. discuss the potential utility of Li-ESWT and its effects on stem cell therapies. The potential mechanisms of Li-ESWT include increased expression of vascular endothelial growth factor, chemokine CXC motif ligand 5, and transforming growth factor-β1. Additionally, Li-ESWT can activate various cellular signaling pathways. Collectively, the biological effects of Li-ESWT include inducing stem cell differentiation, neural regeneration, and angiogenesis. The authors proposed that the combination of Li-ESWT and stem cell therapies might be a promising strategy for treating erectile dysfunction, urinary incontinence, bladder dysfunction, and other urological diseases. However, much more research into the mechanisms by which Li-ESWT enhances the efficacy of stem cell therapy is required before this combined treatment can be recommended for large-scale clinical application.
Mhaske et al. reported a prospective study that evaluated the effectiveness and safety of transperitoneal laparoscopic ureterolithotomy (TPLU) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the surgical management of ureterolithiasis with an average size of calculi >15 mm. They discovered that the operation time and blood loss were relatively higher in the TPLU group than in the RPLU group. Complete stone clearance was observed in both groups. The authors concluded that TPLU and RPLU are feasible procedures for managing large ureteric stones, which are unamenable to ureteroscopy or extracorporeal shockwave therapy.
During the COVID-19 pandemic, the use of social media continued to increase in the field of urology. Huang et al. examined the impact of COVID-19 on the urology residency application cycle on social media engagement and account creation by urology residency programs and applicants. They discovered that the number of urology programs on Twitter and Instagram increased at a faster rate in 2020 than in previous years, especially Twitter, to engage and learn about each other. With the restrictions on travel and in-person interviews due to the COVID-19 pandemic, social media has taken on a new and essential role in the urology match process.
Medical expulsive therapy (MET) has been shown to improve the clearance of ureteral stones, minimizing the requirement for minimally invasive surgery. Pal et al. prospectively evaluated and compared the efficacy of silodosin versus tamsulosin versus oral hydration therapy in MET for ureteral stones between ≥4 mm and ≤10 mm in size. They discovered no difference in stone expulsion rate (SER), stone expulsion time (SET), and surgical intervention between tamsulosin, silodosin, and oral hydration therapy group for ureteric stones ≤5 mm in size. For ureteric stones sized 6–10 mm, silodosin had a higher SER than tamsulosin, with no difference in SET.
The female urethral stricture is an unpleasant urological condition affecting perimenopausal women (PMW). Iyyan et al. evaluated the outcomes of dorsal buccal mucosal graft urethroplasty (BMGU) in nine PMW suffering from urethral stricture disease. The results indicated that the procedure had an overall success rate of 87% with no major complications. They concluded that dorsal BMGU in females for urethral stricture disease offers successful urethral reconstruction and the advantage of little disruption of the continence mechanism and resilience to hormonal changes in PMW.
During the COVID-19 pandemic, acute urolithiasis posed a difficulty because it could be treated with primary ureteroscopy (P-URS) or following temporary measures, including emergency stenting (ES) or nephrostomies, which are followed by deferred/delayed ureteroscopic procedures (D-URS). Wani et al. compared the results of ES with P-URS procedures in terms of quality and cost benefits during the COVID-19 pandemic. They discovered that patients with ES had to undergo D-URS and spent more days and expenditure than patients who received P-URS. They concluded that the approach of P-URS and management of stones in the index admission helps improve patient quality and reduce cost expenditure.
Multiple tracts of PCNL are applied to achieve better staghorn stone clearance. However, creating multiple tracts may increase the risk of bleeding and complication rates compared with single-tract procedures. Tsai et al. reviewed their experience treating staghorn calculi with multiple tracts (n = 17; mean 2.88 tracts; group 2) compared with a single tract (n = 19; group 1).
Their results indicated that the stone-free rates in groups 1 and 2 were 59% and 70.5%, respectively. Interestingly, there2 was no difference in the complication rate between single- and multiple-tract mPCNL. They concluded that multiple-tract mPCNL is a viable alternative method for dealing with more complex or complete staghorn calculi. The same experienced surgeon performing both surgeries will make the study more convincing by minimizing bias caused by the experience of different surgeons.
Most urologists have limited experience with open urethroplasty for posterior urethral distraction defects. Pan et al. reported the outcomes of transperineal urethroplasty in 36 patients with pelvic fracture urethral distraction defects over the past 12 years from Taiwan's largest medical center. This study demonstrated an overall success rate of 83.3% at a mean follow-up duration of 26 months. Age and urethral defect length were identified as the two main factors affecting surgical prognosis.
We hope you find these articles relevant in expanding your knowledge about urology.
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Conflicts of interest
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