Shiliang Wu

The Chinese version of ICIQ: A useful tool in clinical practice and research on urinary incontinence

In China, more and more research on the management of urinary incontinence (UI) is being conducted; a robust questionnaire to evaluate the symptoms and impact of UI will be very helpful. Thus, the Chinese version of The International Consultation on Incontinence Questionnaire (ICIQ) was developed.

Development and comparison of a Chinese nomogram adding multi-parametric MRI information for predicting extracapsular extension of prostate cancer

Purpose To improve the performation of a nomogram for predicting side-specific extracapsular extension (SS-ECE). Results One hundred and ninety-six patients (55.5%) had ECE on final pathology. Bilateral and unilateral ECE rate was 13.9% (49/353) and 41.6% (147/353), respectively. The mean age was 65.9 years and the mean serum prostate specific antigen (PSA) was 15.0 ng/ml. Based on multivariate logistic regression analysis, clinical stage (cStage), PSA, Gleason sum, percentage of positive cores, and ECE risk score were significant predictors of ECE. The current nomogram had higher predictive accuracy (0.851) and superior calibration. According to the decision curve analysis (DCA) results, the updated nomogram demonstrated a high net benefit across a wide range of threshold probabilities. Materials and Methods We studied 353 patients with cStage T1c-T3 prostate cancer underwent radical prostatectomy. The candidate predictors associated with ECE were cStage, PSA, Gleason sum, percentage of positive cores, maximum cancer percentage and ECE risk score from multi-parametric magnetic resonance imaging (MP-MRI). The receiver operating characteristic (ROC) analysis was performed and an updated nomogram was constructed. The DCA was performed to test the predictive ability of the nomogram. In addition, the validation and calibration of the Memorial Sloan-Kettering cancer center (MSKCC) nomograms were performed in the current subjects. Conclusions Predictors, including cStage, PSA, Gleason sum, percentage of positive cores, maximum cancer percentage, and ECE risk score, were combined to construct a SS-ECE prediction nomogram. And the current nomogram might help urologists in decision-making process of preserving or resecting neurovascular bundles preoperatively.

Expression of programmed death ligand-1 on bladder tissues is detected in a clinically and histologically well-defined interstitial cystitis cohort

To investigate the expression of programmed death ligand‐1 (PD‐L1) in interstitial cystitis (IC).

Urodynamic characteristics of pelvic lipomatosis with glandular cystitis patients correlate with morphologic alterations of the urinary system and disease severity.

To explore urodynamic characteristics and their clinical value in pelvic lipomatosis (PL) patients.

Correlation of benign prostatic obstruction-related complications with clinical outcomes in patients after transurethral resection of the prostate

We aim to investigate the correlation of benign prostatic obstruction (BPO)‐related complications with clinical outcomes in patients after transurethral resection of the prostate in China. We reviewed the medical history of all patients who underwent surgery from 1992 to 2013. We assessed the preoperative clinical profile, clinical management, and operative complications. Overall, 2271 patients were enrolled in the study. Of these patients, 1193 (52.5%) had no BPO‐related complications and 1078 (46.3%) had BPO‐related complications. Compared with patients without BPO‐related complications, those with BPO‐related complications were older (pu2009=u20090.001) and usually had other urologic comorbidities (pu2009=u20090.003). Additionally, they tended to have more tissue resected (pu2009<u20090.001), a higher American Society of Anesthesiologists grade (pu2009=u20090.002), and larger prostates (pu2009<u20090.001). Nonetheless, there was no obvious difference in surgical complications between both groups (pu2009>u20090.05). Among patients with BPO‐related complications, compared with the bladder stone group, only the bladder stone+u2009group tended to have a greater urinary infection risk after transurethral resection of the prostate. Compared with patients with one or two BPO‐related complications, those with three BPO‐related complications tended to have a higher risk of pulmonary embolism and acute coronary syndrome (pu2009<u20090.05). Despite the widespread use of medication, patients with BPO‐related complications were older and had larger prostates; however, transurethral resection of the prostate is still considered a safe and recommended surgical treatment. Nevertheless, those with three or more complications were at a higher risk of severe complication after surgery, and active surgical intervention is needed once BPO‐related complications develop.

A nomogram predicting re-operation due to secondary hemorrhage after monopolar transurethral resection of prostate

We aim to develop a nomogram to predict re‐operation due to secondary hemorrhage after Monopolar transurethral resection of the prostate (M‐TURP). We identified patients undergoing M‐TURP at Peking University First Hospital from 2000 to 2013. Univariate and multivariate logistic regression models were developed to predict the occurrence re‐operation due to secondary hemorrhage. The discriminatory ability of the nomogram was tested using the area under the receiver operating characteristic curve (ROC), and internal validation was performed via bootstrap resampling. Of the 1901 patients who underwent M‐TURP during the study period, 9.1% (173 patients) experienced hemorrhage after M‐TURP, and they had a 22.0% re‐operation rate (38 patients). Benign prostatic hyperplasia (BPH)‐related complications (odds ratio, 0.386; 95% CI, 0.177–0.841), percent of resected prostate (OR, 0.156; 95% CI, 0.023–1.060) and suprapubic cystostomy (OR, 0.298; 95% CI, 0.101–0.881) were independently associated with re‐operation. The nomogram accurately predicted re‐operation (area under the ROC curve 0.718). The negative predictive value was 88.0%, while the positive predictive value was 47.9%. Re‐operation due to secondary hemorrhage after M‐TURP was associated with no BPH‐related complications, lower percent of resected prostate and no suprapubic cystostomy and was accurately predicted with using the nomogram.

Are prostate biopsies necessary for all patients 75 years and older

PURPOSEnTo develop nomograms predicting prostate cancer (PCa) and high-grade PCa (HGPCa) in the elderly population.nnnMETHODSnWe reviewed the data of patients aged 75years and older who underwent first-time prostate biopsy and multiparametric magnetic resonance imaging (mpMRI). The nomograms were developed based on multivariate analysis and evaluated. We performed the external validation and calibration of the risk calculators from the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the Prostate Cancer Prevention Trial (PCPT).nnnRESULTSnThe present study included 302 subjects with a median age of 78years (range: 75-91years). Overall, 225 and 129 subjects were diagnosed with PCa and HGPCa (Gleason score≥4+3), respectively. The ratio of free-to-total PSA, prostate-specific antigen density (PSAD), transrectal ultrasound (TRUS), and Prostate Imaging Reporting and Data System (PI-RADS) were used to develop the PCa-predicting nomogram, and PSAD, TRUS, and PI-RADS were used to develop the HGPCa-predicting nomogram. The area under the curve (AUC) values of PCa-predicting and HGPCa-predicting nomograms were 0.90 and 0.87. The ERSPC calculator had acceptable external calibration and validation outcomes. We recommended a cut-off probability of 42% for PCa-predicting nomogram when used in healthy older men to achieve a sensitivity of 95.6%, and a cut-off probability of 73% for HGPCa-predicting nomogram when used in vulnerable older men to achieve a specificity of 98.3%.nnnCONCLUSIONSnThe present nomograms could help discriminate patients with PCa from healthy elder adults for standard treatment, and discriminate patients with HGPCa from vulnerable elder adults for modified treatment. External validation is expected.

Repair of complex vesicovaginal fistulas by combining a rotational bladder flap and full thick vascular peritoneal interposition

To present the experience of repairing iatrogenic vesicovaginal fistulas (VVFs) using a rotational bladder flap and peritoneal interposition technique.

AB013. Retroperitoneal laparoscopic surgery for the upper urinary tract: the Institute of Urology, Peking University (IUPU) technique

Objective We introduce the innovative Institute of Urology, Peking University (IUPU) techniques for retroperitoneal laparoscopic surgery for the upper urinary tract, which have been published by Department of Urology, Peking University First Hospital and Institute of Urology, Peking University, and promote their widespread use in the field of urology. Methods We summarized the innovative retroperitoneal laparoscopic techniques published in medical journals by our department. Results There are more than 10 innovative techniques in retroperitoneal laparoscopic surgery which have been published in influential journals by IUPU. These include: (I) the modified patient positioning for retroperitoneal laparoscopic surgery; (II) the IUPU technique to set up the retroperitoneal space; (III) the anatomical retroperitoneoscopic nephrectomy; (IV) the laparoscopic aspiration technique for central or giant renal angiomyolipoma; (V) the combined retroperitoneal and transperitoneal pathway for pure laparoscopic radical nephrectomy and inferior vena cava (IVC) tumor thrombectomy; (VI) for megaureter, the laparoscopic ureteral reimplantation technique with extracorporeal tailoring and direct nipple ureterocystostomy; (VII) the modified standardized suturing for UPJO; (VIII) the complete retroperitoneal laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma (UTUC). Conclusions These IUPU innovative or modified techniques have improved the treatment efficacy for related diseases and contributed to the progress of our department.