Current Urology Reports最新文献

{"title":"Strategies and Best Practices for Engaging Urology Residents in Clinical Research during Training.","authors":"Kate Dwyer, Elisabeth M Sebesta","doi":"10.1007/s11934-025-01317-w","DOIUrl":"10.1007/s11934-025-01317-w","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: In this review, we will explore the benefits of urology resident participation in research during training and identify the common barriers for residents to engage in scholarly activity. Most importantly, we aim to discuss strategies to foster engagement in research during urology residency training despite time constraints, resource limitations, and competing clinical demands. RECENT FINDINGS: Recent literature on the topic highlights that while urology residency programs require some form of scholarly activity, few offer extended dedicated research time and there is no minimum requirement for promotion or graduation across programs. Protected research time, structured curricula, and available mentorship are associated with increased research productivity. Encouraging innovative approaches such as longitudinal research exposure and integrated research didactics, incentivization and reward culture, fostering high-quality mentorship, and standardizing expectations have shown some success in improving publication rates and promoting conference presentations. The benefits of residents participating in research during training include refined clinical thinking, promotion of evidence-based practice, and facilitating academic career opportunities. We hope to offer a roadmap for programs and educators to consider how to cultivate the culture of inquiry needed to promote resident research engagement without the need to extend training. By starting this conversation, we aim to inspire urology training programs to prioritize research integration in a way that prepares residents to contribute meaningfully to scientific advancement and ultimately improve patient care. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"9"},"PeriodicalIF":3.2,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Sterility: the Urinary Microbiome in Bladder Cancer Carcinogenesis and Treatment.","authors":"Stephanie Aron, Margaret Meagher, Sarah Azari, Benjamin Baker, Ryan Nasseri, Aditya Bagrodia, Tyler Stewart, Michael Liss, Amirali Salmasi","doi":"10.1007/s11934-025-01315-y","DOIUrl":"10.1007/s11934-025-01315-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Emerging evidence has challenged the paradigm of bladder sterility, opening new opportunities for understanding bladder cancer biology.</p><p><strong>Recent findings: </strong>Disruption of commensal intravesical bacterial communities appears to increase risk of carcinogenesis, while the presence of specific bacterial strains has been linked to differential treatment responses. However, the interplay between urinary microbiome and bladder cancer remains incompletely defined. This review summarizes the current literature regarding the role of urinary microbiome in the pathogenesis and treatment outcomes, highlights limitations of existing studies, and outlines future directions for incorporating microbiome profiling into personalized management strategies.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"8"},"PeriodicalIF":3.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of Point of Care Ultrasound in Urology Residency Training: A Practical Framework for Curriculum Design and Implementation.","authors":"Eric J Macdonald, Andrew Williams, Ryan L Steinberg, William Faust, Agustin Perez-Londoño, Ruslan Korets","doi":"10.1007/s11934-025-01311-2","DOIUrl":"10.1007/s11934-025-01311-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Point-of-care ultrasound (POCUS) has become an indispensable diagnostic and procedural tool across many medical specialties. However, formalized ultrasound training within urology residency programs remains limited. This review aims to outline a practical framework for designing and implementing a structured POCUS curriculum tailored specifically to urology training.</p><p><strong>Recent findings: </strong>Various programs have implemented POCUS curricula, often with longitudinal instruction, modular content, hands-on training, and competency-based assessments. While urology has historically relied on sporadic exposure, often limited to prostate biopsies or intraoperative imaging, recent integration into the residency training demonstrates the utility of ultrasound amongst all urologic organs. National surveys of residents and practicing urologists reveal persistent deficiencies in both confidence and formal training opportunities, despite high interest and perceived clinical value. A review of emerging urology-specific curricula shows that programs adopting structured, multimodal approaches, combining didactics, video-based learning, supervised training, and simulation report improvements in user confidence, technical proficiency, and clinical utilization. Early data suggest that when implemented longitudinally, these frameworks can help to broaden ultrasound use in clinical settings. However, published experiences remain limited to a small number of institutions, underscoring the need for broader utilization and interventional studies. Current literature supports a structured POCUS curriculum for urology trainees, yet widespread adoption remains at an early stage. A unified framework could help standardize expectations, ensure equitable training experiences, and better prepare residents for modern practice. Multi-institutional collaboration, increased research on educational outcomes, and potential guidance from accrediting bodies will be critical to advancing ultrasound education and establishing national standards for urologic POCUS training.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"7"},"PeriodicalIF":3.2,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Urinary Stone Disease in Pregnancy: Integrating Current Guidelines with Emerging Evidence.","authors":"Aleksandra M Golos, Alejandra Barreto, Ellen M Cahill, Marianne Casilla-Lennon","doi":"10.1007/s11934-025-01316-x","DOIUrl":"10.1007/s11934-025-01316-x","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Urinary stone disease is among the most common non-obstetric conditions in pregnancy and carries significant maternal-fetal morbidity. Diagnosis and management are challenging, as the accuracy and efficacy of different modalities must be balanced against their pregnancy-specific risks. This narrative review evaluates society guidelines and emerging evidence on stone disease in pregnancy, focusing on population-based and comparative studies published since 2010. RECENT FINDINGS: Adverse maternal-fetal outcomes associated with urinary stone disease in pregnancy may be exacerbated by delays and inconsistencies in care. Ultrasound is the recommended first-line imaging modality, but diagnostic accuracy is limited; emerging evidence supports low-dose CT as an alternative when diagnostic certainty is required. Conservative management remains the standard initial approach in uncomplicated cases. Evidence regarding tamsulosin in medical expulsive therapy is inconclusive. When surgical management is necessary, prompt decompression should be considered; ureteral stenting may be favored over percutaneous nephrostomy in certain cases. Primary ureteroscopy is increasingly supported as a safe and effective definitive treatment. Management of urinary stone disease in pregnancy is challenging and demands a multidisciplinary, patient-centered approach. Practice patterns are highly variable, both reflecting and contributing to the limited scope of current guidelines. Further research is needed to establish comprehensive, evidence-based guidelines. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"6"},"PeriodicalIF":3.2,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Considerations in Penile Implantation Revision Surgery from a Global Perspective.","authors":"Ahmad Majzoub","doi":"10.1007/s11934-025-01313-0","DOIUrl":"10.1007/s11934-025-01313-0","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Penile prosthesis revision surgery represents a critical yet underexplored aspect of men’s health care. While primary penile prosthesis implantation offers a durable solution for erectile dysfunction unresponsive to medical therapy, complications such as infection, mechanical failure, and patient dissatisfaction often necessitate revision procedures. These surgeries are inherently more complex than primary implantations, requiring greater perioperative resources and incurring higher costs. This review synthesizes global evidence on the economic implications of penile prosthesis revision surgery, with a focus on clinical, procedural, and systemic cost drivers. RECENT FINDINGS: Evidence from both urologic and analogous surgical fields highlights the heightened resource utilization and complication rates associated with revision procedures, particularly in the presence of infection or corporal fibrosis. Device-related considerations, institutional capacity, and healthcare policy play significant roles in determining cost and accessibility. Variations in insurance coverage and access across health systems further underscore disparities in timely and equitable care. Comparative data also demonstrate that revision surgeries carry greater perioperative complexity and higher healthcare expenditure than primary implantations. Penile prosthesis revision surgery should be recognized as a distinct and necessary component of sexual medicine services. Risk-adjusted reimbursement models, improved procedural coding, and regionalization of care to high-volume centers are recommended to optimize outcomes and control costs. Addressing disparities in access and ensuring cost-conscious delivery will be essential for advancing equitable and effective care in this field. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"5"},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12769708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Considerations in the Management of Nonobstructive Azoospermia in the United States.","authors":"Mitsuru Komeya, Sohei Kuribayashi, Camryn Hawkins, Jayant Siva, Scott D Lundy","doi":"10.1007/s11934-025-01305-0","DOIUrl":"10.1007/s11934-025-01305-0","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: To identify the principal cost drivers in U.S. management of NOA and evaluate evidence-based strategies—particularly the sequencing of mTESE and the surgical venue—that can lower out-of-pocket spending without compromising success RECENT FINDINGS: mTESE provides ≈10 % higher sperm-retrieval than conventional TESE but adds an additional US 9.6 k, almost 50 % less than synchronized “fresh” cycles because IVF fees are spared when no sperm are ultimately obtained. This savings, however, comes at a theoretical decrease in overall success given the attrition that occurs with sperm cryopreservation. Office-based TESE under local anaesthesia may minimize surgical charges by up to 90 % while maintaining satisfactory outcomes for the right patient. Surveys show 64 % of U.S. men still pay >US $15 k out-of-pocket, as state mandates rarely cover male procedures. Staging mTESE before IVF, shifting suitable cases to clinic settings, and using dynamic institutional cost models can markedly reduce financial barriers while preserving clinical efficacy, guiding value-based NOA care and policy. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"4"},"PeriodicalIF":3.2,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Emerging Role of B Cells and Tertiary Lymphoid Structures in Bladder Cancer.","authors":"Andrew Penunuri, Eliyahu Greenberg, John Phillips, Andrew B Katims","doi":"10.1007/s11934-025-01314-z","DOIUrl":"10.1007/s11934-025-01314-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide a comprehensive review of new and emerging literature on B cells and tertiary lymphoid structures (TLS) in urothelial cancer.</p><p><strong>Recent findings: </strong>The presence of certain subsets of B cells and TLS in MIBC are associated with improved outcomes and response to immunotherapy. However, the role in NMIBC is less clear. TLS in NMIBC is likely associated with more aggressive disease but may also be associated with improved outcomes to intravesical BCG. This review outlines an emerging potential biomarker (TLS) for predictive and prognostic outcomes for patients with urothelial cancer receiving either intravesical BCG or systemic immunotherapy. B cells play a complex role in the tumor immune microenvironment and can be either anti- or pro-tumor. Activated B cells form TLS which lead to a robust response to immunotherapy. This has led some investigators to attempt therapeutic manipulation to induce TLS in otherwise immunologically \"cold\" tumors.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"3"},"PeriodicalIF":2.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating A Positive Professional Culture: Addressing Academic Bullying.","authors":"Elizabeth Soo, Casey Seideman","doi":"10.1007/s11934-025-01310-3","DOIUrl":"10.1007/s11934-025-01310-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to define academic bullying, describe its prevalence and impact, and explore multi-level approaches for addressing this form of workplace mistreatment and enacting reform.</p><p><strong>Recent findings: </strong>Academic bullying is a prevalent form of workplace mistreatment that contributes to poor patient satisfaction, physician burnout, and medical errors. Numerous factors have been proposed as potential reasons for widespread prevalence, including established hierarchy, cultural tolerance, and lack of institutional reporting processes. Evidence suggests that certain populations including women, underrepresented minority members, and LGBTQ + individuals are at greater risk of experiencing academic bullying. This review outlines academic bullying in medicine, including its definition, prevalence, and impact. Here, we describe populations at increased risk of experiencing academic bullying and consolidate proposed solutions to address this mistreatment. Main findings include that vulnerable populations include women, underrepresented minority individuals, and members of the LGBTQ + community and that future solutions include a multilevel approach at the national, institutional, and individual levels.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"2"},"PeriodicalIF":3.2,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Neck Incision in Posterior Urethral Valve Management: a Meta-Analysis with Insights into Adjunctive Bladder Interventions.","authors":"Mohamed Tharwat, Reham Ramadan, Abdelwahab Hashem, Diaa-Eldin Taha, Mohamed Hussiny, Ahmed Elkashef, Tamer E Helmy, Mohamed S Dawaba, Ashraf T Hafez","doi":"10.1007/s11934-025-01309-w","DOIUrl":"10.1007/s11934-025-01309-w","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: To evaluate the outcomes of bladder neck incision (BNI) and alternative treatments, such as alpha blockers, in improving voiding dysfunction in posterior urethral valve (PUV) after valve ablation (VA). RECENT FINDINGS: Eleven studies comprising 826 patients with PUV were included. Concomitant BNI and VA significantly improved both VUR resolution (Risk Ratio “RR”= 1.36; 95% CI: 1.04–1.79), and postoperative serum creatinine -0.16 (95% CI: -0.28 to -0.04). Concomitant BNI and VA significantly improved detrusor overactivity (RR = 0.44; 95% CI: 0.22–0.91; p = 0.03), and reduced significantly maximum detrusor pressure at Qmax (Pdetmax) by-23.53 (95% CI: -35.01 to -12.05). It also significantly decreased both the use of alpha blocker/anticholinergic (RR = 0.59; 95% CI: 0.36 to 0.95), and the need for intermittent catheterization (RR = 0.16; 95% CI: 0.03 to 0.83; p = 0.03). However, there were no significant difference either in bladder compliance (RR = 0.75; 95% CI: 0.31 to 1.79), nor children required re-intervention (RR = 0.52; 95% CI: 0.25 to 1.05). Alpha blockers after VA showed a pooled post-void residual urine reduction of -59.44 (95% CI: -129.05 to 10.17). The pooled estimate for peak flow rate with alpha blockers was 14.22 (95% CI: 13.70–14.74). BNI combined with valve ablation could improves bladder function and reduces the need for additional interventions compared to VA alone. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12727795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine Culture in Endourology - Clinical Relevance, Strengths and Controversies.","authors":"Francesco Ripa, Elisa De Lorenzis, Federica Passarelli, Stefano Paolo Zanetti, Luca Boeri, Giancarlo Albo, Emanuele Montanari, Bhaskar Somani","doi":"10.1007/s11934-025-01312-1","DOIUrl":"10.1007/s11934-025-01312-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review evaluates the role of urine culture (UC) in preoperative assessment for endourological stone procedures. It addresses the optimal timing of UC, its predictive value compared to urinalysis, the interpretation of mixed flora, and the utility of repeat cultures after antibiotic treatment. In addition, it explores emerging molecular methods that may refine perioperative infection risk assessment.</p><p><strong>Recent findings: </strong>UC remains the gold standard for identifying infection risk, but several controversies persist. Studies suggest urine dipstick testing can complement or even outperform UC in certain contexts, while mixed flora results often do not justify antibiotic therapy. Evidence indicates that prolonged preoperative antibiotic prophylaxis reduces postoperative sepsis in high-risk patients, though repeat UC after treatment has limited predictive value. Novel approaches such as next-generation sequencing and molecular diagnostics offer higher sensitivity but risk overdiagnosis. Preoperative UC remains indispensable for risk assessment in endourology, though its limitations demand a more nuanced, risk-adapted approach. Integration of urinalysis, selective repeat testing, and emerging molecular diagnostics could refine perioperative decision-making while supporting antimicrobial stewardship.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"80"},"PeriodicalIF":3.2,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}