Urology research & practice最新文献

{"title":"Comparison of STONE, Guy's Stone, and Seoul National University Renal Stone Complexity (S-ReSC) Scoring Systems for PCNL Monotherapy in Staghorn Stones.","authors":"Santhosh Srinivasan, Sharanya Padma, Abdul Azeez Ambalath, Poulose Chally, Pankaj Bhirud","doi":"10.5152/tud.2025.24128","DOIUrl":"https://doi.org/10.5152/tud.2025.24128","url":null,"abstract":"<p><strong>Objective: </strong>Accurate evaluation of staghorn stones is crucial for predicting the likeli hood of achieving stone-free status through percutaneous nephrolithotomy. Scoring systems such as the Stone size, Tract length, Obstruction, Number of calyces, Essence of stone density (STONE) score, Guy's Stone score, and Seoul National University Renal Stone Complexity (S-ReSC) score have been developed to quantify stone complexity and guide clinical decision-making.</p><p><strong>Methods: </strong>This was a prospective comparative study conducted with 52 staghorn calculi patients. Grading of the stone was done by using 3 scoring systems. An imaging study using ultrasound kidneys, ureters, and bladder was performed for early detection of remnant fragments to determine stone-free rate on postoperative day 4. Postoperative complications were categorized by using Clavien-Dindo classification system. Receiver operating characteristic curves were constructed to evaluate the predictive value of 3 stone criteria on the stone-free rate.</p><p><strong>Results: </strong>According to the Guy's Stone score and S-ReSC score systems, all patients with grade IV and high complexity stones had residual stones by the end of POD 4. In contrast, the STONE criteria reported that 11.1% of high complexity stones were stone free. All 3 stone scoring systems indicated a significant increase in the occurrence of complications with increasing stone complexity. The S-ReSC scoring system exhibited the highest AUC of 0.831, indicating it has superior predictive performance compared to Guy's Stone criteria (AUC: 0.790) and the STONE criteria (AUC: 0.765).</p><p><strong>Conclusions: </strong>Among the STONE, Guy's Stone, and S-ReSC scoring systems, the S-ReSC scoring system has proven to be the most effective for assessing both SFR and complications.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"359-365"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wellness and Prevalence of Hypogonadism Among Male Resident Physicians.","authors":"Basil F Mirza, Gene Austin Krishingner, Kevin J Campbell","doi":"10.5152/tud.2025.24121","DOIUrl":"https://doi.org/10.5152/tud.2025.24121","url":null,"abstract":"<p><strong>Objective: </strong>Hypogonadism is estimated to affect up to 30% of men aged 40-70, with a range of symptoms and health implications. Despite its prevalence, its impact on resident physicians, a group known to experience high levels of stress, irregular sleep patterns, and long working hours, remains largely unexplored. This study aimed to evaluate the prevalence and impact of hypogonadism among male resident physicians.</p><p><strong>Methods: </strong>A prospective study was conducted involving male physicians training at a tertiary referral institution. Participation was offered through distribution to Accreditation Council for Graduate Medical Education (ACGME) program coordinators and program directors. Participants were given the Androgen Deficiency in the Aging Male (ADAM) and 36-Item Short Form Health Survey questionnaires, and underwent labs including testosterone, follicle-stimulating hormone (FSH), luteinizing hormone, and estradiol levels.</p><p><strong>Results: </strong>Of the 651 male trainees, 27 residents were interested in participating for a response rate of 4.1%. Sixty-seven percent (18/27) completed the surveys and 22% (6/27) completed lab work. Two-thirds of the participants who completed the lab work had total testosterone levels below 400 ng/dL, and half of the participants scored positively on the ADAM questionnaire. A total of 44.4% of participants reported that their health was worse compared to a year prior.</p><p><strong>Conclusion: </strong>Male resident physicians are an at-risk population for symptoms and signs of hypogonadism. This population may benefit from screening and interventions aimed at reducing the impact of hypogonadism. The findings of this study underscore the need for further research to confirm these results and explore potential interventions.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"351-354"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Circulating Tumor Cells in T1 Stage Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis.","authors":"Andy Zulfiqqar, Belinda Liliana, Nurul Lantika Mataho, Eko Subekti","doi":"10.5152/tud.2025.24135","DOIUrl":"https://doi.org/10.5152/tud.2025.24135","url":null,"abstract":"<p><p>Non-muscle invasive bladder cancer (NMIBC) presents substantial variability in clinical outcomes, especially in high-grade T1 cases, which exhibit high recurrence and progression rates. Circulating tumor cells (CTCs) have emerged as a potential biomarker for cancer prognosis, with evidence linking CTC positivity to poor outcomes in various cancers. In bladder cancer (BC), studies suggest that CTC presence correlates with advanced tumor stage and treatment response, but findings are inconsistent. This study aims to clarify the association between CTC positivity and recurrence and progression to muscle invasiveness in BC. A comprehensive search was conducted using PubMed, SciVerse Scopus, Google Scholar, and the World Health Organization International Clinical Trials Registry Platform databases up to August 2024. This study focuses on assessing the predictive ability of CTCs for NMIBC recurrence and upstaging after transurethral resection of bladder tumor (TURBT). A total of 5 studies were included. Four of the 5 studies found a significant relationship between CTCs and recurrence after TURBT. The hazard ratio (HR) for recurrences was available in 5 studies, and the estimated pooled odds ratio (OR) predicted the value of recurrences for CTC- positive OR = 2.68 (95% CI: 2.11-3.25; P < .001; fixed-effect). Four studies provided data on disease progression from T1 to T2 after TURBT with an overall HR of 3.36 (95% CI: 2.68-3.25). Circulating tumor cells enhance prognostic accuracy and therapeutic strategies in NMIBC, particularly in high-risk cases. Further studies should address molecular subtype stratification and evaluate systemic chemotherapy for CTC-positive patients.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"343-350"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gap of Research to Practice in IC/BPS: A Scientometric Study of Available Evidence.","authors":"Helia Mostafaei, Hamidreza Ashayeri, Sayeh Afshar, Hadi Mostafaei, Tannaz Aghaei Badr, Hanieh Salehi-Pourmehr, Sakineh Hajebrahimi","doi":"10.5152/tud.2025.24086","DOIUrl":"https://doi.org/10.5152/tud.2025.24086","url":null,"abstract":"<p><p>Our main objective is to first characterize the current status of the research field of interstitial cystitis and bladder pain syndrome (IC/BPS). This is achieved by mapping, analyzing, and sub-analyzing the field with a scientometric approach, which provides insights into future research. In September 2023, the Scopus database was searched without restrictions on language and date. The following search query was used: Bladder* W/5 pain* W/3 syndrome* AND Interstitial* W/3 (Cystitis* OR Cystides) and the Scopus filters were used to exclude short surveys, book chapters, editorials, notes, and guidelines. The author, journal, institution data, keywords, average citation, countries, and sources were transformed using a Biblioshiny tool (A Shiny app for Bibliometrix), accounting for author spelling, institutional naming, and subgrouping variations. The search strategy yielded 1833 studies. The USA was the most cited country, with other countries showing significant growth in recent years. In terms of affiliations, TZU CHI University was the most relevant in this field (n = 154). The most relevant keywords were \"female,\" \"interstitial cystitis,\" \"human,\" \"cystitis interstitial,\" \"male,\" and \"cystalgia.\" The current topics in IC/BPS research are Genome-wide association and Cannabidiols. By understanding the past, scientific gaps, and the direction of the current research, researchers can aim for their research questions and conduct their research more organized. The scientific gaps of IC/BPS can be effectively understood by paying attention to the models used in this research, which are the results of the systemic analysis of the scientific products in this research field.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"332-342"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Men's Health & Sexual Medicine and the Litigious Patient: A Review of Malpractice Cases.","authors":"Sandeep Sai Voleti, Summer Ghaith, Christopher Warren, Nahid Punjani","doi":"10.5152/tud.2025.24163","DOIUrl":"https://doi.org/10.5152/tud.2025.24163","url":null,"abstract":"<p><strong>Objective: </strong>Recent literature suggests growing rates of malpractice claims against urologists. These cases provide insight into errors that may lead to litigation. We aim to analyze malpractice suits related to men's health and highlight clinical presentations and legal outcomes.</p><p><strong>Methods: </strong>Per STROBE guidelines, we searched the publicly available Thomson Reuters Westlaw legal database for \"jury verdicts and settlements\" from January 1970 to August 2023 to identify medical malpractice cases in Urology. Patient demographics, clinical presentation, alleged error, and legal outcomes were abstracted during a full case review by an independent screener. Cases related to men's sexual health or fertility that named a urologist as the defendant were fully analyzed.</p><p><strong>Results: </strong>A total of 553 urology cases were extracted, with 23 men's health related cases subsequently analyzed. The most common conditions associated with litigation were penile prosthesis (39%), epidydimal pathology (13%), and varicocele (13%). The most common allegations were misdiagnosis (26%), surgical complication (22%), lack of informed consent (22%), and violation of standard of care (22%). Of the 23 cases, 57% ruled \"no liability\" in favor of the urologist and 39% ruled in favor of the plaintiff with a median award of $335,000 (IQR = 100 ,000-450, with 000). Among cases ruled as negligent, performing the incorrect procedure, surgical complications, and violating the standard of care were prominent allegations.</p><p><strong>Conclusions: </strong>This study characterizes malpractice cases related to men's sexual health naming urologists as defendants. Obtaining comprehensive informed consent, following national guidelines, and responding appropriately to surgical complications may minimize likelihood of litigation and maximize patient outcomes.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"328-331"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Hand-Assisted Donor Nephrectomy: A Decade of Single-Center Experience and Outcomes.","authors":"Sevim Nuran Kuşlu Çiçek, Amil Huseynov","doi":"10.5152/tud.2025.24161","DOIUrl":"https://doi.org/10.5152/tud.2025.24161","url":null,"abstract":"<p><strong>Objective: </strong>Kidney transplantation is the most effective treatment for end-stage renal disease, but the shortage of cadaveric donors has increased reliance on living donors. Traditional open donor nephrectomy, while effective, is associated with significant morbidity. Hand-assisted laparoscopic donor nephrectomy (HALDN) combines the advantages of minimally invasive surgery with the tactile feedback of open surgery. This study presents the outcomes of HALDN procedures performed at the center.</p><p><strong>Methods: </strong>A total of 1221 living donor nephrectomies performed between September 2009 and August 2021 at Medicana !stanbul Hospital were analyzed. Donor characteristics, surgical details, and postoperative outcomes were recorded. Data analysis was conducted using SPSS version 22.0, with continuous variables assessed for normality and expressed accordingly.</p><p><strong>Results: </strong>Donor ages ranged from 19 to 87 years (mean 48.50 ± 12.75 years), with 54.8% female donors. The average body mass index (BMI) was 27.99 ± 3.7 kg/m2. Left-sided nephrectomies constituted 78.5% of cases, with HALDN performed in 94.7% of these surgeries. Warm ischemia time averaged 99.21 ± 56.67 seconds. The average blood loss was 70 mL, and the mean hospital stay was 4.12 ± 1.2 days. Complications included conversion to open surgery due to bleeding in 3.3% of cases, postoperative atelectasis (0.6%), incisional hernia (0.33%), wound infection (0.16%), and scrotal swelling (0.25%). The findings indicate that HALDN is a safe and effective method for donor nephrectomy, aligning with similar studies regarding operation and warm ischemia times. The minimally invasive nature of HALDN contributes to shorter hospital stays and quicker postoperative recovery. The rate of conversion to open surgery was within acceptable limits, and complications were manageable. Obesity (BMI > 30 kg/m2) was identified as a risk factor for incisional hernia, suggesting the need for careful surgical technique in this group.</p><p><strong>Conclusion: </strong>Hand-assisted laparoscopic donor nephrectomy offers a minimally invasive, safe, and effective alternative for living donor nephrectomy, enhancing donor recovery and potentially encouraging organ donation. Its adoption may play a signifi- cant role in reducing the number of patients awaiting organ transplants.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"355-358"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Partial Nephrectomy A Primary Option for Patients with T1b Renal Cell Carcinoma-A National Population-Based Study.","authors":"Sven Lundstam, Tarik Almdalal, Andreas Karlsson Rosenblad, Börje Ljungberg","doi":"10.5152/tud.2025.24081","DOIUrl":"https://doi.org/10.5152/tud.2025.24081","url":null,"abstract":"<p><strong>Objective: </strong>Renal cell carcinoma (RCC) patients in clinical T1 RCC generally exhibit a favorable prognosis. Guidelines recommend partial nephrectomy (PN), also for cT1b RCCs. Despite a favorable prognosis, there remains risks for upstaging and recurrence for cT1b RCC patients, and the preference for PN has been questionable. Clinical and morphological variables and overall survival (OS) were characterized in a national realworld population.</p><p><strong>Methods: </strong>Data from the the National Swedish Kidney Cancer Register 2005-2014, with non-metastatic cT1bRCC patients treated surgically and having !5 years potential follow-up were included (n = 2006). Patients gender, age, stage, tumor size, RCC type, local and distant tumor recurrence were evaluated.</p><p><strong>Results: </strong>Among 2006 patients (1219 males, 787 females; mean age 66 years), 1705 underwent radical nephrectomy (RN), and 301 PN. Upstage from cT1b to pathological T3a occurred in 304 (15%) patients. Recurrent disease was diagnosed in 318 (16%) patients, with higher rates in pT3a (25%) compared to pT1b (14%). There was no significant difference in disease recurrences observed between the surgical techniques. Factors associated with increased recurrence risk included age, T-stage, N-stage, and tumor size, while papillary and chromophobe RCCs were associated with decreased risk. Patients with pT3a RCC had a worse 5-year OS rate (67%) compared with pT1b (83%; P < .001, log-rank test). In adjusted analyses, age, tumor size, pT-stage, and pN- stage were associated with OS, while treatment with PN was non-inferior compared with RN (hazard ratio 0.91, 95% CI: 0.71-1.45, P = .431).</p><p><strong>Conclusion: </strong>Patients with clinical T1b RCCs face a non-negligible risk for tumor upstaging, disease recurrence, and decreased OS. The adjusted analyses showed that PN was non-inferior to RN, supporting the recommendation to offer PN.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 6","pages":"322-327"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of the Efficacy and Tolerability of Palmex® (Roystonea regia Lipid Extract), Saw Palmetto, Finasteride and Tamsulosin in Patients with Benign Prostatic Hyperplasia.","authors":"Raúl Guzmán Mederos, Mónica Reyes Bello, Julio César Fernández Travieso, Manuel Pedroso Gastón, Sigfredo Calzadilla Feijoo, Miriam Hernández Rech, Maria de Los Angeles Viamontes Lu, Yenney Reyes Nuñez, Jilma Mena Figueroa, Zunilda Rodríguez Suárez, Lai López Rodríguez, Niurka Basulto Turran, Yolanda Cruz Gómez, Meilis Mesa Angarica, Sarahí Mendoza Castaño, Maytee Robaina García, Gladys Jiménez Rivero","doi":"10.5152/tud.2025.24067","DOIUrl":"https://doi.org/10.5152/tud.2025.24067","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate and compare the efficacy and tolerability of the treatment with Palmex®, saw palmetto, finasteride, or tamsulosin administered for 6 months to patients with benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>This multicenter, open, prospective, comparative study was conducted in men !40 years with mild and moderate BPH according to the International Prostate Symptoms Score (IPSS) (!1, <19). The study included 200 patients (50 per group) who were randomly allocated to receive Palmex® (320 mg/d), saw palmetto (320 mg/d), finasteride (5 mg/d), or tamsulosin (0.4 mg/d). The primary study outcome was the improvement of the maximum urinary flow (Qmax), while significant decreases in IPSS values, prostate size, and residual post-voiding volume were secondary efficacy variables. Statistical analysis was performed according to Intention to treat.</p><p><strong>Results: </strong>The demographic baseline characteristics of all the groups were similar. All groups exhibited a significant mean increase in Qmax from baseline to week 24, being 3.8 mL/s (27.7%), 3.6 mL/s (23.1%), 4.2 mL/s (28.6%), and 4.1 mL/s (26.3%) on Palmex®, saw palmetto, finasteride, and tamsulosin, respectively. Likewise, all the treatments significantly reduced the IPSS scores by 74.2% (Palmex®), 74.6% (saw palmetto), 60.3% (finasteride), and 74.2% (tamsulosin), also decreasing the prostate size and the residual post-voiding volume. No significant differences among the groups were found regarding any efficacy variable. The treatments were well tolerated.</p><p><strong>Conclusion: </strong>Palmex® for 6 months demonstrated to have a comparable efficacy to saw palmetto, finasteride, and tamsulosin in patients with mild and moderate BPH, being safe and well tolerated.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 5","pages":"302-309"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Penile Girth and Length in the Erect State in Reassuring Patients with Small Penis Anxiety.","authors":"Sameh Fayek GamalEl Din, Nashaat Ismail Nabil, Mohamed A Khalil, Amgad Elseginy, Mohamed Ahmed AbdElSalam","doi":"10.5152/tud.2025.24133","DOIUrl":"https://doi.org/10.5152/tud.2025.24133","url":null,"abstract":"<p><strong>Objective: </strong>The present study examined the impact of measuring penile girth and length in the erect state on reassuring individuals with small penis anxiety (SPA) in the flaccid state.</p><p><strong>Methods: </strong>This study included 200 potent men aged 25-40 years old. All candidates were assessed by the validated Arabic version of the International Index of Erectile Function (ArIIEF-5), Hospital Anxiety and Depression Scale (HADS), Beliefs about Penile Size, and Cosmetic Procedure Screening questionnaires. Participants were divided into 100 healthy participants and 100 participants with SPA. We measured penile length and girth in the flaccid state in participants with SPA. After 2 weeks, we measured penile length and girth in the erect state by injecting 0.25 cc diluted prostaglandin E1 (PGE-1) in the corporeal bodies. Also, participants with SPA were reassessed by the ArIIEF-5 and the HADS in the erect state.</p><p><strong>Results: </strong>Penile length in the flaccid state was in the normal range 9.33 ± 0.81 cm that increased to 10.37 ± 0.89 cm in the erect state. The penile girth in the flaccid state was also in the normal range 8.08 ± 0.85 cm that increased to 9.33 ± 0.85 cm in the erect state. Significant decreases in the scores of HADS after PGE-1 injection were noted, denoting improvement in the patient's quality of life. The ArIIEF-5 score insignificantly increased after re-counseling in the erect state. Despite a significant reduction in anxiety and depression levels after re-counseling in the erect state, yet, they did not show any correlation with the penile dimensions in the flaccid and the erect states.</p><p><strong>Conclusion: </strong>Although the current study failed to demonstrate significant correlations between penile dimensions in the erect state and the ArIIEF-5 and the HADS scores. Yet, there was significant decrease in HADS score and insignificant increase in ArIIEF-5 score denoting that men with SPA should be counseled in the erect state.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 5","pages":"316-321"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-Analysis of Penis Length and Circumference According to WHO Regions: Who has the Biggest One?","authors":"Hadi Mostafaei, Keiichiro Mori, Satoshi Katayama, Fahad Quhal, Benjamin Pradere, Takafumi Yanagisawa, Ekaterina Laukhtina, Frederik König, Reza Sari Motlagh, Pawel Rajwa, Hanieh Salehi-Pourmehr, Sakineh Hajebrahimi, Shahrokh F Shariat","doi":"10.5152/tud.2025.24038","DOIUrl":"https://doi.org/10.5152/tud.2025.24038","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to perform a systematic review and meta-analysis of stretched, erect, and flaccid penis length as well as circumference according to geographic WHO regions.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, and Cochrane Library were searched for articles published until February 2024. Studies in which a healthcare professional evaluated the penis size were considered eligible. After assessing the risk of bias, a systematic review and meta-analyses were performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement, and the outcomes were grouped based on the WHO regions.</p><p><strong>Results: </strong>A total of 33 studies comprising 36 883 patients were included. The risk of bias in the included studies was moderate/low. A comprehensive systematic review was done and meta-analyses performed for flaccid length [n = 28 201, mean (SE) 9.22 (0.24) cm], stretched length [n = 20 814, mean (SE) 12.84 (0.32) cm], erect length [n = 5669, mean (SE) 13.84 (0.94) cm], flaccid circumference [n = 30 117, mean (SE) 9.10 (0.12) cm], and erect circumference [n = 5168, mean (SE) 11.91 (0.18) cm]. The mean length of the stretched penis was largest in Americans [14.47 (0.90) cm]. The mean length of the flaccid penis was the largest in the Americas [10.98 (0.064) cm]. The mean flaccid penile circumference was largest in Americans [n = 29 714, mean (SE) 10.00 (0.04) cm].</p><p><strong>Conclusions: </strong>Penis sizes vary across WHO regions, suggesting the need to adjust standards according to geography to better understand councilmen and their partners. These data provide a framework for discussing body image expectations and therapeutic strategies in this sensitive and emotional subject matter.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 5","pages":"291-301"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}