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Minagawa T. Recent developments in diagnostic ultrasound for lower urinary tract function. J Med Ultrason (2001) 2024:10.1007/s10396-024-01494-0. [PMID: 39327335 DOI: 10.1007/s10396-024-01494-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 08/05/2024] [Indexed: 09/28/2024]
Abstract
Ultrasonography (US) is an essential tool in the clinical management of lower urinary tract dysfunction (LUTD), including lower urinary tract symptoms, overactive bladder, and benign prostatic hyperplasia, in which prostatic volume and post-void residual volume are routinely used to evaluate the pathophysiological characteristics of afflicted patients. US can also be employed to diagnose hydronephrosis and bladder calculus as complications of severe LUTD. Moreover, US is essential for identifying pathophysiological characteristics and surgical indications, predicting disease development and drug efficacy, and monitoring bladder function improvement by means of such parameters as bladder wall thickness, prostatic urethral length, intravesical prostatic protrusion, and prostatic urethral angulation/angle. Herein, I narratively review the recent advances in US approaches for the management of LUTD, especially in adult males.
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Affiliation(s)
- Tomonori Minagawa
- Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
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Murakami Y, Sazuka T, Tsukamoto R, Sato H, Ando K, Kanesaka M, Yamada Y, Imamura Y, Sakamoto S, Ichikawa T. Association Between Residual Urine Volume and Recurrence Among Patients at High Risk of Non-Muscle-Invasive Bladder Carcinoma With Versus Without Bacillus Calmette-Guérin Treatment. Cureus 2024; 16:e61345. [PMID: 38947615 PMCID: PMC11214650 DOI: 10.7759/cureus.61345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
Non-muscle-invasive bladder carcinoma often occurs in older adults, who often also have urinary dysfunction. The residual urine volume is an important indicator of urinary dysfunction. However, the impact of the residual urine volume on intravesical recurrence remains unclear. In the present study, we analyzed the data of 372 patients at high or very high risk of cancer progression according to the Japanese Urological Association classification who had undergone transurethral resection of a bladder tumor. In univariate analysis, postoperative absence of intravesical Bacillus Calmette-Guérin (BCG) induction was an independent risk factor for intravesical recurrence (hazard ratio 1.94, absence versus presence, p = 0.0019). The incidence of intravesical recurrence did not significantly differ between the mild, intermediate, and severe residual urine groups in the total cohort. Among the BCG-treated cohort, the three groups showed similar trends. Among the non-BCG-treated cohort, although the patients with more than 100 ml of residual urine tended to have more intravesical recurrence than patients with a smaller residual urine volume, this difference did not reach statistical significance. BCG treatment is recommended for patients at high risk of bladder carcinoma. Patients with a large residual urine volume without BCG treatment may be at high risk of intravesical recurrence.
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Affiliation(s)
- Yuki Murakami
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Tomokazu Sazuka
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Ryo Tsukamoto
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Hiroaki Sato
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Keisuke Ando
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Manato Kanesaka
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Yasutaka Yamada
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
| | - Yusuke Imamura
- Urology, Chiba University Graduate School of Medicine, Chiba, JPN
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Tsukamoto R, Sazuka T, Hattori Y, Sato H, Arai T, Goto Y, Imamura Y, Sakamoto S, Ichikawa T. Relationship between Preoperative Pyuria and Bacille Calmette-Guerin Treatment in Intravesical Recurrence after Transurethral Resection of High-Risk, Non-Muscle Invasive, Bladder Carcinoma: A Retrospective Study of Human Data. Cancers (Basel) 2023; 15:cancers15061638. [PMID: 36980524 PMCID: PMC10046501 DOI: 10.3390/cancers15061638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
Some researchers have found that preoperative pyuria is a risk factor for recurrence after transurethral resection of high-risk non-muscle invasive bladder cancer. However, to our knowledge, none have clarified the risks associated with pyuria according to bacille Calmette-Guerin (BCG) treatment status. We retrospectively selected patients with high-risk non-muscle invasive bladder cancer according to Japanese Urological Association guidelines. Pyuria was defined as ≥10 white blood cells per high-powered field. We analyzed recurrence-free rates (RFS) in 424 patients who had and had not undergone BCG treatment. The median duration of follow-up was 45.2 months. According to multivariate analysis, postoperative intravesical BCG induction and preoperative pyuria were independent risk factors for intravesical recurrence in the whole study cohort. We found no significant risk factors for recurrence in the BCG-treated group (n = 179). In the non-BCG-treated group (n = 245), patients with pyuria were much more frequently female and more often had T1 disease than patients without pyuria. According to univariate and multivariate analysis, preoperative pyuria is an independent risk factor for intravesical recurrence. There was no significant difference in the severity of pyuria between the BCG and non-BCG-treated groups. Aggressive BCG treatment may need to be considered in patients with high-risk NMIBC and pyuria.
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Affiliation(s)
| | - Tomokazu Sazuka
- Correspondence: ; Tel.: +81-43-226-2134; Fax: +81-43-226-2136
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Does post-void residual urine volume affect potential recurrence risk for non-muscle invasive bladder cancer? Future Sci OA 2022; 8:FSO823. [PMID: 36788983 PMCID: PMC9912276 DOI: 10.2144/fsoa-2022-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/08/2022] [Indexed: 01/25/2023] Open
Abstract
Aim Bladder cancer is the second most common urological malignancy after prostate cancer. Increase in the post-void residual (PVR) volume may result in an increase in the risk of cancer recurrence. Methods Patient demographic data, tumor stage and grade, PVR volume and 2 years follow-up data for recurrence were obtained and evaluated. Results One-hundred-and-nineteen patients were subdivided into three groups according to PVR urine volume. The increase of PVR volume was related to short recurrence-free survival (RFS) especially for patients with PVR volume of 60 ml or more. Conclusion Low PVR volume in patients with non-muscle invasive bladder cancer may play a role in reducing cancer recurrence. However further research is needed in this field.
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To Explore the Diagnostic Value of Bulbocavernosus Muscle Reflex and Pudendal Somatosensory Evoked Potentials for Diabetic Neurogenic Bladder. DISEASE MARKERS 2022; 2022:6096326. [PMID: 36157205 PMCID: PMC9492348 DOI: 10.1155/2022/6096326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/25/2022]
Abstract
Objective To explore the diagnostic value of bulbocavernosus muscle reflex and pudendal somatosensory evoked potentials for diabetic neurogenic bladder. Methods From January 2021 to December 2021, 104 patients with type 2 diabetes mellitus admitted to the hospital were recruited, with 57 allocated to the case group and 47 to the control group. Outcome measures included bulbocavernosus muscle response, pudendal somatosensory evoked potentials, and bladder residual urine volume. The connection of bulbocavernosus muscle response and pudendal somatosensory evoked potentials with bladder residual urine volume was investigated using the Pearson analysis. Results In both males and females, the latency of the left and right bulbocavernosus muscle reflexes in the case group was longer than in the control group, but the difference was not statistically significant (P > 0.05), and the wave amplitude of the left and right bulbocavernosus muscle reflexes was significantly smaller than that of the control group (P < 0.05). The diabetic neurogenic bladder was associated with a significantly longer latency and a smaller wave amplitude of pudendal somatosensory evoked potentials versus without neurogenic bladder (P < 0.05). Patients with a diabetic neurogenic bladder had more residual bladder urine volume versus those without (P < 0.05). Bladder residual urine volume was significantly positively correlated with bulbocavernosus muscle reflex and pudendal somatosensory evoked potential latency and negatively correlated with wave amplitude (P < 0.05). Conclusion The bulbocavernosus muscle reflex and pudendal somatosensory evoked potentials demonstrate great potential as adjuncts to diagnose diabetic neurogenic bladder and correlate with ultrasound results in determining bladder function in patients.
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Matsushita Y, Kawakami A, Sato R, Watanabe K, Watanabe H, Tamura K, Motoyama D, Ito T, Sugiyama T, Otsuka A, Miyake H. Significant impact of a history of prior or concomitant upper urinary tract cancer on the recurrence and progression of non-muscle invasive bladder cancer. Jpn J Clin Oncol 2022; 52:944-949. [DOI: 10.1093/jjco/hyac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The objective of the present study was to evaluate the prognostic impact of the upper urinary tract cancer status on recurrence-free survival and progression-free survival, and to develop risk stratification systems that include the upper urinary tract cancer status for patients with non-muscle invasive bladder cancer.
Patients and Methods
The present study included 40 (upper urinary tract cancer-non-muscle invasive bladder cancer group) and 285 (non-muscle invasive bladder cancer alone group) patients with and without a history of prior or concomitant upper urinary tract cancer, respectively. Nine clinicopathological findings between the two groups were compared, and risk stratification systems for the recurrence and progression of non-muscle invasive bladder cancer were developed.
Results
Recurrence-free survival and progression-free survival in the upper urinary tract cancer-non-muscle invasive bladder cancer group were significantly inferior to those in the NMIBC alone group (P < 0.001 and P = 0.006, respectively). Multivariate analyses identified the following independent prognosticators: multiplicity and upper urinary tract cancer status for recurrence-free survival, and pT category and upper urinary tract cancer status for progression-free survival. Significant differences were noted by the risk stratification systems based on the positive number of independent predictors of recurrence-free survival and progression-free survival (P < 0.001 and P = 0.007, respectively). The concordance indices of recurrence-free survival were 0.627, 0.588 and 0.499 in this study stratification, EORTC risk table and CUETO model, respectively. Those of progression-free survival were 0.752, 0.740 and 0.714, respectively.
Conclusion
The present results suggest the significant impact of a history of prior or concomitant UUTC on recurrence-free survival and progression-free survival in non-muscle invasive bladder cancer patients, and risk stratification systems that include the upper urinary tract cancer status for the recurrence and progression of non-muscle invasive bladder cancer are promising tools for predicting the outcomes of these patients.
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Affiliation(s)
- Yuto Matsushita
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Asuka Kawakami
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Ryo Sato
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kyohei Watanabe
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hiromitsu Watanabe
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Keita Tamura
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Daisuke Motoyama
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Toshiki Ito
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Takayuki Sugiyama
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Atsushi Otsuka
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Büttner T, Ritter M. Sonographie von Nieren, Retroperitoneum und Harnblase. Urologe A 2022; 61:357-364. [DOI: 10.1007/s00120-022-01791-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 10/18/2022]
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Tan C, Jiang Y, Song S, Li X, Zhou C. Therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi: a randomized controlled trial. Wideochir Inne Tech Maloinwazyjne 2021; 16:536-542. [PMID: 34691303 PMCID: PMC8512516 DOI: 10.5114/wiitm.2021.106425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Upper urinary tract calculus is a common disease of the urinary system. AIM To compare the therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi. MATERIAL AND METHODS A total of 146 patients were randomly divided into control and experimental groups (n = 73). The control group received flexible ureteroscopy lithotripsy, and the experimental group underwent the same but combined with external physical vibration. The rate of finding stones in the urine on the day after treatment, clearance rate, components of stones, levels of renal function indices blood urea nitrogen (BUN) and serum creatinine (Scr), and incidence of complications were compared. The stone-free rate during 1-year follow-up was analysed by Kaplan-Meier method. RESULTS The rate of finding stones in the urine on the day after treatment was higher in the experimental group (100%) than that in the control group (29.73%) (p < 0.05). The clearance rates on the day, at 1 week, and at 2 weeks after treatment in the experimental group were 71.23%, 87.67%, and 95.89%, respectively, which surpassed those of the control group at corresponding time points (p < 0.05). BUN and Scr levels decreased after treatment in both groups, especially in the experimental group (p < 0.05). The stone-free rate during 1-year follow-up in the experimental group (n = 71 (97.26%)) exceeded that of the control group (n = 61 (83.56%)) (p < 0.05). CONCLUSIONS External physical vibration combined with flexible ureteroscopy lithotripsy significantly increased the rate of finding stones in the urine the day after treatment, the clearance rate of upper urinary tract calculi, and the ameliorated renal function and reduced the stone re-formation rate.
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Affiliation(s)
- Cheng Tan
- Medical Examination Centre, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, China
| | - Yongbao Jiang
- Medical Examination Centre, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, China
| | - Shanshan Song
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang Province, China
| | - Xiaoge Li
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang Province, China
| | - Chunliang Zhou
- Ningbo University of Finance and Economics, Ningbo, Zhejiang Province, China
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Kojima T. Editorial Comment from Dr Kojima to Relationship between post-void residual urine volume, preoperative pyuria and intravesical recurrence after transurethral resection of bladder carcinoma. Int J Urol 2020; 27:1031. [PMID: 32990342 DOI: 10.1111/iju.14395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Takahiro Kojima
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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UroVysion ® predicts intravesical recurrence after radical nephroureterectomy for urothelial carcinoma of the upper urinary tract: a prospective study. Int J Clin Oncol 2020; 26:178-185. [PMID: 32959230 DOI: 10.1007/s10147-020-01785-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Intravesical recurrence (IVR) after radical nephroureterectomy (RNU) for urothelial carcinoma of the upper urinary tract (UCUUT) is common. One of the mechanisms driving this is the implantation of cancer cells from the UCUUT at the RNUs. Therefore, their detection after RNU can assist in predicting IVR. This study aimed to examine the utility of UroVysion® as a tool for predicting bladder recurrence after RNU for UCUUT. METHODS We prospectively enrolled 65 patients who received RNU for high-grade UCUUT between October 2013 and April 2017. RESULTS Of the 65 patients, 54 (83.1%) who had both bladder urine samples available immediately after RNU (0 postoperative days: POD) and 5 days after RNU (5POD) were selected. We performed UroVysion® and cytology. Twenty-two patients showed IVR with 32 foci. UroVysion® results at 0POD (26 patients, 48.1%) and/or 5POD (31 patients, 57.4%) were positive in 42 (77.8%) patients. The sensitivity, specificity, positive predictive value, and negative predictive value of UroVysion® for included cases were measured for both 0POD and 5POD samples; they were determined to be 95.5% (21/22), 34.4% (11/32), 50.0% (21/42), and 91.7% (11/12), respectively. For cytology, these values were 75.0% (15/20), 52.9% (18/34), 48.4% (15/31), and 78.3% (18/23), respectively. Forty-two (64.6%) patients who were UroVysion®-positive demonstrated IVR. The IVR rate between the group positive for either 0POD or 5POD and that negative for both significantly differed for both UroVysion® (p = 0.019) and cytology (p = 0.046). CONCLUSION Multiple urine tests using UroVysion® after RNU could be a useful predictor for IVR.
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Sazuka T, Sakamoto S, Imamura Y, Nakamura K, Yamamoto S, Arai T, Takeuchi N, Komiya A, Teishima J, Ichikawa T. Relationship between post-void residual urine volume, preoperative pyuria and intravesical recurrence after transurethral resection of bladder carcinoma. Int J Urol 2020; 27:1024-1030. [PMID: 32875619 DOI: 10.1111/iju.14352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the relationship between residual urine volume, pyuria and bladder carcinoma recurrence. METHODS The clinical data of 305 patients who had post-void residual urine volume measured and preoperative pyuria were retrospectively collected. The patients were classified into three risk groups based on the presence of residual urine and pyuria: good (negative residual urine and pyuria), intermediate (positive residual urine or pyuria) and poor (positive residual urine and pyuria). Predictive factors for intravesical recurrence-free survival were statistically analyzed using Cox proportional hazard models and Kaplan-Meier methods. The propensity score matching method was used to adjust the patients' backgrounds. RESULTS The median follow-up period for all patients was 44 months. The presence of residual urine (P = 0.0164) and pyuria (P = 0.0233) were two independent prognostic factors for recurrence. After patients were classified into risk groups, the poor-risk group showed significantly shorter recurrence-free survival compared with that of the good- (P = 0.0002) and intermediate-risk groups (P = 0.0090). Even after matching, the presence of residual urine was related to short recurrence-free survival in male patients (P = 0.0012). When stratified by European Organization for Research and Treatment of Cancer risk groups, the presence of pyuria was related to short recurrence-free survival, especially for intermediate-risk patients without bacillus Calmette-Guérin treatment. CONCLUSIONS Post-void residual urine and preoperative pyuria are two risks for recurrence-free survival in non-muscle-invasive bladder cancer.
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Affiliation(s)
- Tomokazu Sazuka
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuyoshi Nakamura
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Yamamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Arai
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuyoshi Takeuchi
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Jun Teishima
- Department of Urology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Hatakeyama S, Ohyama C. Editorial Comment to Impact of post-void residual urine volume on intravesical recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma. Int J Urol 2019; 26:1112-1113. [PMID: 31522463 DOI: 10.1111/iju.14113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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