Salient Observations from Clinical Profile and Long-Term Outcome of a Cohort of Patients with Ectopic Cushing's Syndrome.

Introduction: Ectopic adrenocorticotropic hormone (ACTH)/corticotropin-releasing hormone production by tumours causes 5-10% of Cushing's syndrome cases. We present a 21-patient case series with ectopic Cushing's syndrome (ECS) from a tertiary care institute in India.

Methods: Data were collected retrospectively for patients from 1984 to 2004 and prospectively thereafter till 2019.

Expression of ALDH1 isotypes and its potential as a prognostic and diagnostic marker in patients with muscle invasive bladder cancer.

ALDH1 isotype is an established cancer stem cell marker. In this study, immunohistochemical (IHC) expression of ALDH1/2 and ALDH1A3 protein was evaluated in a retrospective cohort of 99 pathologically confirmed MIBC patients and 11 distant normal bladder urothelium. IHC expression was assessed quantitatively using histopathology score (H score).

Comparison of prostate-specific membrane antigen intraprostatic radiological yield score, prostate-specific membrane antigen expression score, and lesion standardized uptake value and their combination with multiparametric MRI for evaluation of clinically significant prostate cancer: a single-center retrospective study.

Objective: To compare the prostate-specific membrane antigen intraprostatic radiological yield (PRIMARY)-score, prostate-specific membrane antigen (PSMA)-expression score, and lesion standardized uptake value (SUV)max and their combination with multiparametric MRI (MpMRI) for the detection of clinically significant prostate cancer (csPC).

Materials And Methods: Our retrospective study analyzed 381 patients with suspicion of prostate cancer who underwent 68 Ga-PSMA PET/computed tomography (CT) between January 2021 and December 2022. Among these, 170 patients also underwent MpMRI.

Perioperative, Functional, and Oncological Outcomes of Robotic-Assisted Partial Nephrectomy in 1,267 Indian Patients: A Multicenter Analysis by the Indian Robotic Partial Nephrectomy (IRPN) Collaborative Group.

Introduction: Robotic-assisted partial nephrectomy (RPN) is increasingly recognized as an effective treatment for small renal masses. This study aims to highlight the therapeutic benefits of RPN for both small and relatively larger renal masses in the Indian population.

Methods: A retrospective chart review was conducted on patients who underwent RPN using the da Vinci surgical system between September 2010 and September 2022 across 14 centers located in various cities of India, including Ahmedabad, Bengaluru, Chandigarh, Chennai, Delhi, Gurugram, Hyderabad, Kochi, and Nadiad.

Lu-PSMA-617 Consolidation Therapy After Docetaxel in Patients with Synchronous High-Volume Metastatic Hormone-Sensitive Prostate Cancer: A Randomized, Phase 2 Trial.

Lu-prostate-specific membrane antigen-617 (Lu-PSMA-617) has shown positive survival outcomes in metastatic castration-resistant prostate cancer. However, there are limited data in the hormone-sensitive setting. Here, in the CONSOLIDATE trial (Lu-PSMA-617 Consolidation Therapy After Docetaxel in Patients with Synchronous High-Volume Metastatic Hormone-Sensitive Prostate Cancer), we intended to evaluate the role of Lu-PSMA-617 as consolidation therapy for residual disease after chemohormonal treatment in patients with synchronous high-volume metastatic hormone-sensitive prostate cancer (mHSPC).

Can 99m Tc-PSMA SPECT/CT Presenting Mirror Image of 68 Ga-PSMA PET/CT Be Used for Response Assessment to 177 Lu-PSMA in Metastatic Castration-Resistant Prostate Cancer?

A 69-year-old man, with a known case of metastatic castration-resistant prostate cancer (mCRPC) underwent 68 Ga-PSMA PET/CT and 99m Tc-PSMA for evaluation of disease burden and response assessment to 177 Lu-PSMA therapy. 99m Tc-PSMA provided a mirror image of 68 Ga-PSMA. This suggests the potential of 99m Tc-PSMA SPECT/CT for disease evaluation and response assessment to PSMA-based radioligand therapies in advanced-stage mCRPC patients, especially when 68Ga-PSMA PET/CT is not available.

Establishing the role of shear wave elastography in differentiating corporal rigidity between vasculogenic versus non-vasculogenic erectile dysfunction patients.

Introduction: Shear wave elastography is a new modality for the evaluation of erectile dysfunction by assessing the stiffness of corpora cavernosal tissue. We evaluated the shear wave elastography values in erectile dysfunction participants and compared shear wave elastography values between vasculogenic and non-vasculogenic erectile dysfunction participants.

Methods: Overall, 40 participants with clinically diagnosed erectile dysfunction filled out an abridged five-item version of the international index of erectile dysfunction-5 questionnaire and underwent shear wave elastography as well as pharmacologically induced penile erection test after intracavernosal papaverine injection.

Up-front dissection of the uterovesical space or "bladder-first approach" reduces hemorrhage and bladder injury during hysterectomy for placenta accreta spectrum: reconfirmed in 78 more cases in a prospective single-center study.

Background: Cesarean hysterectomy for placenta accreta spectrum disorder may be associated with severe hemorrhage because of placental invasion of the myometrium and the uterovesical space or parametrium. It leads to serious complications, such as massive hemorrhage requiring massive transfusion, coagulopathy, bladder and ureteric injuries, need for intensive care unit admission and prolonged hospital stay. To reduce the complications of cesarean hysterectomy for placenta accreta spectrum disorder, ongoing efforts are being made to develop different surgical approaches.

Indian consensus statements on the management of small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.

No pan-India-specific guidelines exist for the management of urological cancers. Although western guidelines are useful for informing management strategies, they do not account for the nuances of management in the Indian context. A modified Delphi method was used to provide a framework for the systematic development of India-centric guidelines for the management of three uro-oncology disease states: small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.

Utility of Image Morphometry in the Atypical Urothelial Cells and High-Grade Urothelial Carcinoma Categories of the Paris System for Reporting Urinary Cytology.

Introduction: Urinary cytology (UrCy) is highly sensitive to diagnosing high-grade urothelial carcinoma (HGUC) but cannot predict muscularis propria invasion. Further, the atypical urothelial cell category (AUC) may have variable outcomes. Image morphometry (IM) may be a valuable adjunct technique in this setting.

Utility of UroVysion Fluorescence in situ Hybridization in Improving the Diagnostic Performance of Urine Cytology.

Introduction: The atypical urothelial cell (AUC) category in The Paris System (TPS) in urine cytology (UrCy) is a challenging area. This study aimed to evaluate the UroVysion fluorescence in situ hybridization (U-FISH) assay in predicting the outcome of AUC. Additionally, we explored the association of abnormal U-FISH results in high-grade urothelial carcinoma (HGUC) concerning muscularis propria invasion (MPI).

Prognostic significance of Klotho expression in patients with renal cell carcinoma.

Introduction: Various molecular markers have been investigated in renal cell carcinoma (RCC) without significant reliability. We analyzed Klotho (tumor suppressive protein) expression in RCC to investigate its association with tumor-stage, grade, disease-free-survival (DFS) and overall-survival (OS).

Methods: Data of histologically confirmed patients of RCC with complete clinical follow-up were retrieved from Medical-Record-Library.

Perioperative and functional outcomes following robot-assisted partial nephrectomy: Descriptive analysis of Indian study group on partial nephrectomy database.

Introduction: There is an unmet need for high-quality data for Robot-assisted partial nephrectomy (RAPN) in the Indian population. Indian study group on partial nephrectomy (ISGPN) is a consortium of Indian centers contributing to the partial nephrectomy (PN) database. The current study is a descriptive analysis of perioperative and functional outcomes following RAPN.

Clinical study of steroid receptors in nonmuscle invasive bladder cancer: A domain worth revisiting.

Introduction: The prognostic significance of steroid receptors in bladder cancer remains controversial. This study was designed to determine the expression status of androgen receptor (AR), estrogen receptors (ERα and Erβ), and its potential role in predicting survival in patients with nonmuscle invasive bladder cancer (NMIBC).

Methods: Sixty patients of NMIBC were screened and 57 (41 males and 16 females) were included in our study.

Potential role of Ga-PSMA PET/CT in metastatic renal cell cancer: A prospective study.

Purpose: Prostate-specific membrane antigen (PSMA), in addition to its utility in prostate cancer, is also an angiogenic imaging marker for hypervascular tumors like renal cell carcinoma (RCC). Our study aims to assess the potential role of Ga-PSMA-11 positron emission tomography (PET)/CT in metastatic RCC and compare it with contrast-enhanced computed tomography (CECT).

Methods: Biopsy-proven RCC patients with known or suspected distant metastases who underwent Ga-PSMA-11 PET/CT for staging/restaging were prospectively recruited.

Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway.

Introduction: Prostate-specific antigen (PSA) is a reliable biomarker for identification of prostate cancer, although a biopsy is still the gold standard for detecting prostate cancer. Similar to higher PIRADS lesions on MRI, the maximal standard uptake value (SUV max) on PSMA PET is linked to a higher likelihood of prostate cancer. Can an mpMRI in conjunction with PSMA PET Scan accurately predict prostate cancer and further trigger omission of biopsy similar to other solid organ urological malignancies?

Methods: Ga-68 PSMA PET and mpMRI were performed for each patient who was a part of this retrospective study.

[Lu]Lu-PSMA-617 Versus Docetaxel in Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer: Final Survival Analysis of a Phase 2 Randomized, Controlled Trial.

The prostate-specific membrane antigen (PSMA) inhibitor [Lu]Lu-PSMA-617 has been previously demonstrated to be noninferior to docetaxel in achieving a biochemical response in chemotherapy-naïve metastatic castration-resistant prostate cancer patients. Here, we report the final analysis of overall survival (OS) for a phase 2 randomized, controlled trial. Forty chemotherapy-naïve, PSMA-positive metastatic castration-resistant prostate cancer patients were randomly assigned to [Lu]Lu-PSMA-617 ( = 20) or docetaxel ( = 20).

Extensively Drug-Resistant Klebsiella pneumoniae Associated with Complicated Urinary Tract Infection in Northern India.

Klebsiella pneumoniae (Kp), which is associated with hospital-acquired infections, is extensively drug-resistant (XDR), making treatment difficult. Understanding the genetic epidemiology of XDR-Kp can help determine its potential to be hypervirulent (hv) through the presence of siderophores. We characterized the genomes of 18 colistin-resistant XDR-Kp isolated from 14 patients with complicated tract infection at an Indian healthcare facility.

Preoperative Predictors for the Presence of Motile Spermatozoa in the Epididymis and Patency of Anastomosis during Microsurgical Vasoepididymal Anastomosis in Patients with Obstructive Azoospermia.

Background: Following microsurgical vaso-epididymal anastomosis (VEA), anastomotic patency with sperm returning to the ejaculate is not always present and may even be delayed. The presence of motile spermatozoa is highly suggestive of future patency following surgery.

Aims: We prospectively analyse the factors that could predict motile spermatozoa at the epididymis intraoperatively and predictors of patency in patients with obstructive azoospermia (OA) undergoing microsurgical VEA.

Epididymo-orchitis Presenting as Bilateral Hydrocele in a Young Adult.

We present a case of young patient who presented with a progressive scrotal swelling and low-grade fever. An ultrasound of the scrotum revealed multiple small well-defined hypoechoic lesions in both testes with bulky epididymis and bilateral hydrocele. The final diagnosis was confirmed on cytology.