Explore the vast range of titles available.

Kidney cancer is a common malignancy that constitutes around 5% of all cancer cases. Males are twice as likely to acquire renal cell carcinoma (RCC) compared to females and experience a higher rate of mortality. These disparities indicate that sex hormone (SH)-dependent pathways may have an impact on the aetiology and pathophysiology of RCC. Examination of SH involvement in conventional signalling pathways, as well as genetics and genomics, especially the involvement of ribonucleic acid, reveal further insights into sex-related differences. An understanding of SHs and their influence on kidney cancer is essential to offer patients individualized medicine that would better meet their needs in terms of prevention, diagnosis and treatment. This review presents the understanding of sex-related differences in the clinical manifestation of kidney cancer patients and the underlying biological processes.

Background and Objectives: We aimed to assess the outcomes of upfront Optilume drug-coated balloon (DCB) dilation in patients after failed treatment for complex recurrent urethral stricture disease. All patients presented with acute urinary retention and were treated with DCB dilation regardless of stricture site and length. Materials and Methods: We retrospectively evaluated patients with acute urinary retention and known complex recurrent urethral strictures. Patients presented at the urology emergency room of our tertiary centre with an inability to void or a post-void residual (PVR) volume exceeding 400 mL between August 2021 and February 2024. Urethrography and/or endoscopic imaging confirmed the diagnosis. Patients with urinary tract infection/sepsis and those with neurological disease were excluded. Urethral dilation to 20 Fr was performed, followed by DCB dilation (30 Fr, 10 bar, 10 min). The primary endpoints were anatomical success (≥14 Fr by cystoscopy/calibration) at 12 months and freedom from repeat interventions. Results: Thirty-one consecutive male patients were evaluated, with twenty-six patients followed for ≥12 months (mean age 65 ± 16.8 years). The stricture sites included seven bulbopenile, seven bulbomembranous, seven anastomotic, three bladder neck, one penile, and one panurethral stricture. The median number of prior urethral/surgical interventions was 2 [IQR: 1–3] (range: 1–31). The median stricture length was 3 [IQR: 2–4] cm (range: 1–8). At 12 months, 65.4% (17/26) of subjects voided satisfactorily and were free of recurrence and reoperation. Conclusions: Timely DCB dilation may offer a viable treatment option for patients with complex recurrent urethral strictures and urinary retention, particularly those who are unable or unwilling to undergo surgical reconstruction and prefer to avoid indwelling catheters.

Background Current guidelines recommend repeat computed tomography (CT) imaging in high-grade blunt renal injury within 48–96 h, yet diagnostic value and clinical significance remain controversial. The aim of this work was to determine the possible gain of CT re-imaging in uncomplicated patients with blunt renal trauma at 48 h after injury, presenting one of the largest case series. Methods A retrospective database of patients admitted to our centre with isolated blunt renal trauma due to sporting injuries was analysed for a period of 20 years (2000–2020). We included only patients who underwent repeat imaging at 48 h after trauma irrespective of AAST renal injury grading (grade 1–5) and initial management. The primary outcome was intervention rates after CT imaging at 48 h in uncomplicated patients versus CT scan at the time of clinical symptoms. Results A total of 280 patients (mean age: 37.8 years; 244 (87.1%) male) with repeat CT after 48 h were included. 150 (53.6%) patients were classified as low-grade (grade 1–3) and 130 (46.4%) as high-grade (grade 4–5) trauma. Immediate intervention at trauma was necessary in 59 (21.1%) patients with high-grade injuries: minimally invasive therapy in 48 (81.4%) and open surgery in 11 (18.6%) patients, respectively. In only 16 (5.7%) cases, intervention was performed based on CT re-imaging at 48 h (low-grade vs. high-grade: 3.3% vs. 8.5%; p  = 0.075). On the contrary, intervention rate due to clinical symptoms was 12.5% (n = 35). Onset of clinical progress was on average (range) 5.3 (1–17) days post trauma. High-grade trauma (odds ratio [OR] grade 4 vs. grade 3 , 14.62;  p  < 0.001; OR grade 5 vs. grade 3 , 22.88, p  = 0.004) and intervention performed at the day of trauma (OR 3.22;  p  = 0.014) were powerful predictors of occurrence of clinical progress. Conclusion Our data suggest that routine CT imaging 48 h post trauma can be safely omitted for patients with low- and high-grade blunt renal injury as long as they remain clinically stable. Patients with high-grade renal injury have the highest risk for clinical progress; thus, close surveillance should be considered especially in this group.

Background Normal ultrasound values for pole-to-pole kidney length (LPP) are well established for children, but very little is known about normal kidney size and its influencing factors in adults. The objectives of this study were thus to establish normal CT values for kidney dimensions from a group of unselected patients, identify potential influencing factors, and to estimate their significance. Methods In multiphase thin-slice MDCTs of 2.068 kidneys in 1.040 adults, the kidney length pole to pole (LPP), parenchymal (PW) and cortical width (CW), position and rotation status of the kidneys, number of renal arteries, pyelon width and possible influencing factors that can be visualized, were recorded from a volume data set. For length measurements, axes were adjusted individually in double oblique planes using a 3D-software. Analyses of distribution, T-tests, ANOVA, correlation and multivariate regression analyses were performed. Results LPP was 108.5 ± 12.2 mm for the right, and 111.3 ± 12.6 mm for the left kidney (p < 0.0001 each). PW on the right side was 15.4 ± 2.8 mm, slightly less than 15.9 ± 2.7 mm on the left side (p < 0.0001), the CW was the same (6.6 ± 1.9 mm). The most significant independent predictors for LPP, CW, and PW were body size, BMI, age, and gender (p < 0.001 each). In men, the LPP increases up to the fifth decade of life (p < 0.01). It is also influenced by the position of the kidneys, stenoses and number of renal arteries (SRA/NRA), infarctions suffered, parapelvic cysts, and absence of the contralateral kidney; CW is influenced by age, position, parapelvic cysts, NRA and SRA, and the PW is influenced in addition by rotation status (p < 0.05 each). Depending on the most important factors, gender-specific normal values were indicated for these dimensions, the length and width in cross section, width of the renal pelvis, and parenchyma-renal pyelon ratio. Conclusions Due to the complex influences on kidney size, assessment should be made individually. The most important influencing factors are BMI, height, gender, age, position of the kidneys, stenoses and number of renal arteries.

Background A supernumerary kidney (SK) is an additional kidney with its own capsule and blood supply that is not fused with the ipsilateral kidney (IK). Because individual case reports indicate a high morbidity rate, the aim of this retrospective study was a detailed analysis of this rare anatomical variant. Methods Our systematic imaging-based search for SKs, conducted in the period from 2000 and to 2017, yielded 9 cases in total (5 men, 4 women; mean age: 51.8 ± 22.8 years). Results The SKs were observed on the right in six and on the left side in three cases. In six subjects (66%) they were located caudal and in three cases (33%) cranial to the ipsilateral kidney. Calculi were found in three (33%) of the renal collecting systems. Five (56%) of the SKs had hydronephrosis grade IV and one SK had recurrent pyelonephritis (11%). Two of the ureters opened into the ipsilateral seminal vesicle (22%). Two (22%) SKs were functional but atrophic. Clinically relevant findings were made in 33% of the IKs: atrophy ( n  = 2), calculi ( n  = 1), and reflux with recurrent pyelonephritis ( n  = 1); another 33% had anatomical anomalies without functional impairment. The correct diagnosis of a SK is possible using CT imaging in all subjects. The prevalence of SK based on CT imaging can be estimated to be 1:26750. Conclusions CT is the method of choice for visualizing SKs. The correct diagnosis is crucial in preventing dispensable surgical procedures and for providing optimal patient treatment and outcome.

Vanadium is named after Vanadis, the most aristocratic of Norse goddesses, who symbolises beauty and fertility - essential features of vanadium chemistry. It is a ubiquitous trace element, with a surprising range of biological functions. In Bioinorganic Vanadium Chemistry, Dieter Rehder addresses the major aspects of  vanadium chemistry related to living organisms and the mutual impact between biological and inorganic vanadium chemistry. Topics covered include: the history, natural occurrence, distribution and impact of vanadium inorganic aspects of the function of vanadium in biological systems interaction of aqueous vanadate and vanadyl with biogenic ligands vanadium coordination compounds the vanadium-carbon bond methods of characterisation of biogenic and model vanadium systems (EPR and ENDOR for oxovanadium(IV); 51V NMR for vanadium(V); XAS) vanadium in ascidians and polychaeta worms the concentration of vanadium in the form of amavadin by Amanita mushrooms vanadate-dependent haloperoxidases vanadium and the nitrogen cycle vanadate as energiser for bacteria, and vanadophores medicinal aspectsm including the anti-diabetic potential of vanadium compounds interaction of vanadium with proteins and protein substrates vanadium and phosphate-metabolising enzymes Bioinorganic Vanadium Chemistry conveys the essential aspects of vanadium bioinorganic chemistry, making this book a valuable complement to more general bioinorganic chemistry texts and more specialized topical reviews for researchers and students alike.

Background/Objectives: Reconstruction of membranous urethral strictures poses significant surgical challenges, including risks of urinary incontinence and erectile dysfunction. Optilume drug-coated balloon dilation (DCBD) is a minimally invasive treatment for short, recurrent bulbar urethral strictures, but its application in strictures involving the sphincteric urethra remains controversial. This study aims to evaluate the safety, efficacy, and impact on continence of DCBD in membranous urethral strictures involving the male sphincter. Methods: A retrospective analysis was conducted on 53 consecutive patients with urethral strictures involving the sphincteric urethra, treated with Optilume DCBD between June 2021 and June 2025 at a tertiary center. After preoperative imaging, dilation to 20 Fr, then DCBD (30 Fr, 10 bar, 10 min) were performed. We assessed anatomical success (≥18 Fr as per cystoscopy/calibration), freedom from re-intervention, and continence status. Patients with neurological conditions or urinary infections were excluded. Results: The cohort included 35 membranous urethral strictures and 18 vesicourethral anastomosis stenoses that extended into the sphincter. The median follow-up was 13.3 months. At last follow-up, 66.6% and 65.6% of patients in both groups were free from recurrence and re-intervention with satisfactory voiding. No de novo incontinence was observed; two patients with prior post-prostatectomy incontinence remained incontinent. The median age was 68 years; median prior interventions were 2.5, and median stricture length was 3 cm. Conclusions: Optilume DCBD appears to be a safe and effective option for membranous urethral strictures involving the sphincter, without inducing de novo incontinence. Although not a replacement for reconstruction, it offers a minimally invasive alternative for selected patients.

The question is whether the urethral sphincter may be reconstructed after longitudinal injury similar to anal sphincter injuries. Analogue to obstetric, anal sphincter repair, an approximation repair of the sphincter may be feasible. An overlap repair is possible in anal sphincter repair, but because of the little tissue available in the urethral sphincter this is not an option. We describe three cases of urethral sphincter injury of different aetiologies. All resulted in a total longitudinal disruption of the muscular components of the urethral sphincter complex. After making the diagnosis of urethral sphincter injury, a primary approximation repair was done. Follow-up of at least two and up to three years is promising with one male patient being completely continent and the two female patients needing one safety pad per day. Longitudinal disruption of the muscular elements of the sphincteric urethra may be primarily reconstructed with good success using an approximation technique with simple interrupted sutures.

New and minimal invasive single incision mid-urethral sling procedures are available for treating female stress urinary incontinence. We present a case of a massive retropubic hematoma in a patient with a \"corona mortis\" artery following a minimal invasive sling procedure. The patient was managed conservatively. The hematoma resolved and the patient remained continent after surgery. Nature and symptoms of sling-related complications should prompt the diagnosis and appropriate postoperative management. One should always be conscious of possible vascular anomalies that might lead to unexpected complications.

Ralf Herwig 1 and Salvatore Sansalone 2 and Peter Rehder 3 1, Department of Reconstructive Urology, Andrology and Men's Health, Vienna Urology Foundation, 1010 Vienna, Austria 2, Department of Urology, University of Rome \"Tor Vergata\", Via Orazio Raimondo 18, 00173 Rome, Italy 3, Department of Urology, Medical University of Innsbruck, 6020 Innsbruck, Austria Received 28 December 2014; Accepted 28 December 2014; 23 February 2015 This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. S. Sansalone et al. demonstrate that patients affected by mild-moderate ED may significantly benefit from oral therapy with this special mixture of natural ingredients by improving sexual and ejaculation function and sexual quality of life.