Current Urology Reports最新文献

{"title":"Models and Metrics for Medical Education in Urology: Medical Student Education, Resident Education, and Future Directions.","authors":"Lakshay Khosla, Kayla M Keenan, Jay D Raman","doi":"10.1007/s11934-025-01308-x","DOIUrl":"10.1007/s11934-025-01308-x","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: The purpose of this review is to characterize contemporary models and metrics for medical education in Urology. RECENT FINDINGS: Innovative models involve using augmented reality and 3D-printing to enhance stimulation-based training; these are cost-effective and improve surgical skill metrics. Virtual didactics are preferred since they offer flexible self-paced learning. Structured frameworks (e.g., PREDICT, GAPS) increase graduated autonomy without negative impact on patient care. For medical students, Urology interest groups and mandatory skills sessions significantly boost interest and confidence in basic procedures, with targeted outreach helping to address disparities. Effective urology education requires standardization, flexibility, and autonomy for residents, and early, equitable exposure for medical students. Integrating evidence-based novel models, supported by technology and Artificial Intelligence for content and feedback, is critical for preparing trainees in the evolving field of Urology. Future research should focus on comparative studies to validate these novel educational models against traditional approaches. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"79"},"PeriodicalIF":3.2,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713764","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 Consideration for the Treatment of Peyronie's Disease: A Narrative Review.","authors":"Maxine Parkinson, Ari P Bernstein, Matthew J Ziegelmann","doi":"10.1007/s11934-025-01306-z","DOIUrl":"10.1007/s11934-025-01306-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Peyronie's disease (PD) is an acquired penile deformity that causes penile shortening, narrowing, erectile dysfunction, and pain. Current treatment modalities include penile traction therapy (PTT), Collagenase Clostridium histolyticum (CCh) injections, and surgical straightening procedures which have varying levels of expected deformity correction and associated side effects. Similarly, these treatments have varying levels of both out-of-pocket and total costs for the healthcare system as a whole. This review aims to summarize the current literature regarding the costs of treatment modalities available for PD.</p><p><strong>Recent findings: </strong>Current well-supported treatment options for PD can be categorized into three groups: PTT, CCh, and surgical straightening. CCh injection therapy is gaining popularity but remains the single most expensive therapy for PD. PTT has demonstrated modest curve reduction efficacy, and may be an approachable initial therapy modality for select patients. Penile plication and penile plaque incision/excision surgery are more definitive surgical options that are less expensive than CCh injections but more expensive than PTT. While the literature continues to evolve with emerging guidelines and FDA approvals, PTT remains the lowest absolute cost option while CCh injections and penile plication surgery are the higher cost options. PTT and injection therapy are time intensive which must be taken into account in any discussion of cost-effectiveness. More research remains to be performed to consider cost-effectiveness of various treatment options for PD patients while taking into account efficacy, opportunity cost, and patient quality of life. Urologists treating patients with PD must understand the economic aspects of the evolving treatment landscape to effectively guide management for each patient to enhance quality of life and patient outcomes.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"78"},"PeriodicalIF":3.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707593","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":"Revision of Failed Artificial Urinary Sphincter: A Comprehensive Review.","authors":"Mohamed Ramez, O Lenaine Westney, Thomas G Smith","doi":"10.1007/s11934-025-01299-9","DOIUrl":"10.1007/s11934-025-01299-9","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This paper presents a thorough review of the management of patients requiring revision of a previously placed artificial urinary sphincter. The symptoms at presentation and clinical evaluation, along with surgical techniques, are described in detail. RECENT FINDINGS: Fortunately for the urologic surgeon, revision and replacement of the artificial urinary sphincter is an uncommon event. Recent research on the procedure focuses on strategies to prevent future revision surgeries, such as a modified surgical technique or interposition of flaps or tissue substitutes between the urethra and the sphincter cuff. Revision and replacement surgery for an artificial urinary sphincter is a challenging procedure requiring thorough pre-operative evaluation, detailed knowledge of the male perineal anatomy, and a surgical plan that includes multiple surgical approaches for any given patient. Future research should focus on the identification of patient factors and prevention of device complications to prevent or reduce the need for revision surgery. </p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"76"},"PeriodicalIF":3.2,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667607","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":"Urologic Symptom Management in Parkinson's Disease - Current Treatments and Emerging Directions - Systematic Review.","authors":"Omer Anis, Saar Anis, Myles M Reed, Daniel Teixeira-Dos-Santos, Shelley Ivary, Tyler Trump, Howard B Goldman","doi":"10.1007/s11934-025-01297-x","DOIUrl":"10.1007/s11934-025-01297-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review synthesizes current evidence on therapeutic strategies for Parkinson's disease (PD)-related overactive bladder (OAB), encompassing PD-targeted treatments, pharmacologic interventions, and advanced therapies such as neuromodulation and intravesical botulinum toxin. We address the complexity of managing lower urinary tract symptoms (LUTS) in patients with PD due to progressive neurodegeneration affecting micturition control and cognitive vulnerabilities in this population.</p><p><strong>Recent findings: </strong>A thorough review of available literature shows that chronic levodopa improves bladder capacity and reduces urgency, though acute dosing may worsen symptoms in advanced stages. Subthalamic nucleus-deep brain stimulation enhances bladder function and symptom scores, possibly by modulating basal ganglia-thalamocortical circuits. Anticholinergics are effective but pose cognitive risks, warranting careful use guided by anticholinergic burden assessments. In contrast, beta-3 agonists such as mirabegron offer a safer cognitive profile with emerging efficacy data. Finally, intravesical botulinum toxin and neuromodulation present promising third-line options, though data in PD remain limited, and larger trials are still needed to confirm their role. Optimal management of LUTS in PD requires individualized, stage-specific, multidisciplinary strategies balancing efficacy and cognitive safety. Further high-quality, disease-specific studies are essential to develop tailored treatment algorithms and improve quality of life in this growing patient population.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"77"},"PeriodicalIF":3.2,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667633","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":"Testosterone and Lower Urinary Tract Symptoms: A Narrative Review.","authors":"Colin J O'Mahony, M A Arshad, S M Norton","doi":"10.1007/s11934-025-01307-y","DOIUrl":"10.1007/s11934-025-01307-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>To examine current evidence on the relationship between testosterone and lower urinary tract symptoms (LUTS) in men, focusing on endocrine, metabolic, and inflammatory mechanisms and their implications for clinical practice.</p><p><strong>Recent findings: </strong>Recent studies demonstrate that testosterone influences bladder, prostate, and pelvic floor function through androgen-receptor pathways. Low testosterone amplifies inflammation, oxidative stress, and vascular dysfunction, while metabolic syndrome with associated hypogonadism and sleep disorders exacerbate LUTS severity. Experimental and clinical data confirm that physiologic testosterone therapy does not worsen LUTS or prostate outcomes when appropriately monitored. Testosterone deficiency contributes to LUTS through systemic, not purely anatomical, mechanisms. Restoring physiologic hormone balance and addressing metabolic and sleep factors improves urinary function and quality of life. Future research should prioritise phenotype-specific trials and integrated metabolic-endocrine-urological approaches to refine personalised care for men with LUTS and hypogonadism.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"75"},"PeriodicalIF":3.2,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630965","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 Role of Diet in Kidney Stone Pathogenesis and Prevention.","authors":"Olumide A Ojo, Nyoko Brown, Shelby Yaceczko, Kymora B Scotland","doi":"10.1007/s11934-025-01304-1","DOIUrl":"10.1007/s11934-025-01304-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>The origin of kidney stones is multifactorial, involving a complex interplay of genetic, metabolic, and environmental factors. This review aims to detail the relationship between the molecular pathogenesis of kidney stone disease and the impact diet can have on stone formation and patient outcomes.</p><p><strong>Recent findings: </strong>Diet is an important part of managing kidney stones at a molecular level. Oxalate can be absorbed from the diet through the digestive system into the urine where calcium and oxalate can combine to form stones. Evidence supports that low dietary calcium contributes to first time and recurrent stones, and high dietary sodium elevates the risk of calcium stone formation. Diets high in animal protein cause high levels of urinary uric acid and calcium and low levels of urinary citrate. Low urine pH favors uric acid stone development, and fructose increases serum and urinary uric acid levels. Alternatively, consuming fruits and vegetables raises urinary pH and citrate excretion. Adequate hydration also dilutes urinary solutes and reduces supersaturation. Potassium citrate, magnesium, and calcium supplementation are thought to prevent stone formation. Diet and adequate hydration can manipulate the pathogenesis of stones to prevent recurrence and improve patient outcomes. Calcium oxalate stones are the most common, followed by calcium phosphate, uric acid, struvite, and cystine stones. By aligning nutritional interventions with stone type and metabolic profile, healthcare providers can offer non-invasive methods for improving outcomes.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"74"},"PeriodicalIF":3.2,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548540","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":"Incisional Hernia after Robotic Urological Surgery.","authors":"Alina Gandrabur, Brandon Piyevsky, Faris Najdawi, Mohammad Shahait, Ryan W Dobbs","doi":"10.1007/s11934-025-01303-2","DOIUrl":"10.1007/s11934-025-01303-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize the current evidence on the incidence, risk factors, diagnosis, prevention, and management of incisional hernias following robotic urologic surgery.</p><p><strong>Recent findings: </strong>Emerging evidence has highlighted both surgical and patient-related factors that influence the risk of incisional hernia. Surgical variables associated with higher incidence include midline extraction sites, midline trocar placement, prior abdominal surgery, non-bladed trocar use, and advanced tumor stage. Patient-specific contributors include visceral obesity and rectus diastasis. The financial impact is substantial, with U.S. healthcare expenditures for incisional hernia management estimated at $1.7 billion annually, underscoring the need to optimize surgical technique and patient selection to reduce this burden. Incisional hernia (IH) remains a significant postoperative complication, even with the advent of minimally invasive and robotic surgical techniques. Studies report a variable incidence of IH 0.2-6.3% following robotic prostatectomy, with rates as high as 27% in robotic nephrectomy depending on imaging modality and hernia definition. Diagnosis is commonly made with CT imaging, which remains the gold standard for preoperative planning. Although many IHs are asymptomatic, they may progress to incarceration, necessitating emergency repair with significant morbidity and mortality. Risk factors for IH are multifactorial and include patient-related variables such as obesity, smoking, COPD, diabetes, and rectus diastasis, as well as surgical factors including trocar size and type, extraction site location, and fascial closure technique. Notably, midline and bladed trocar placements are associated with higher hernia risk, while Pfannenstiel extraction and use of non-bladed trocars may be protective. Management strategies remain inconsistent, and preventive measures such as prophylactic mesh, proven effective in general surgery, have yet to be evaluated in urologic robotic procedures. This review summarizes the current literature on IH following robotic urologic surgery, with emphasis on incidence, risk factors, diagnostic modalities, preventive techniques, and potential areas for future research. Given the growing use of robotics in urology and the rising economic burden of IH, better understanding of prevention and early intervention is essential to improving outcomes and reducing healthcare costs.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"73"},"PeriodicalIF":3.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451158","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":"\"Defining the Drip: A Systematic Review of Incontinence Definitions and Predictors Following HoLEP\".","authors":"Carl A Ceraolo, Benedikt M Winzer, Jason D Fairbourn, Dennis Phan, Rajat K Jain, Scott O Quarrier","doi":"10.1007/s11934-025-01296-y","DOIUrl":"10.1007/s11934-025-01296-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>The goal of this paper was to identify the factors contributing to urinary incontinence in patients undergoing holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia by performing a systematic review of the literature.</p><p><strong>Recent findings: </strong>Our search identified 40 randomized studies. Significant heterogeneity existed in defining urinary incontinence in the literature. Many factors contribute to postoperative incontinence after HoLEP, with surgical technique seeming to play the largest role in determining continence outcomes. Refinement of surgical technique is critical to improving continence outcomes after HoLEP. Standardizing definitions of urinary incontinence will enable more reliable comparisons across studies and facilitate better-informed preoperative counseling. Continued investigation is also essential to develop interventions-whether surgical, behavioral, or pharmacologic-that enhance continence recovery and overall quality of life.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"72"},"PeriodicalIF":3.2,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437639","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":"Reviewing the Current State of Renal Cell Carcinoma with a Tumor Thrombus: Epidemiology, Pathophysiology, Metastasis, and Systemic Therapy.","authors":"Maxwell Sandberg, Randall Bissette, Kimberly Waggener, Gaetano Ciancio, Alejandro R Rodriguez","doi":"10.1007/s11934-025-01301-4","DOIUrl":"10.1007/s11934-025-01301-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to highlight relevant literature on the epidemiology and pathophysiology of renal cell carcinoma with a tumor thrombus (RCC-TT), metastatic management, and the role of systemic therapy (ST).</p><p><strong>Recent findings: </strong>Current research indicates different prevalences and presentations by geography, with many classification systems for RCC-TT. Pathophysiology remains poorly understood for TT formation. Some patients may benefit from cytoreductive nephrectomy with tumor thrombectomy (CN-TT) as well as ST administration, but this population is poorly defined. RCC-TT is a complex disease to manage and lacks high-powered publications relative to RCC without a TT. Future research should focus on the genetics behind TT formation and propagation, CN-TT outcomes, and which patients should receive ST and the optimal timing/dosage.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"71"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12578726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421653","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":"Direct-to-Consumer Erectile Dysfunction Medications: is the Convenience Worth the Cost?","authors":"Michelle K Li, Darshan P Patel, Tung-Chin Hsieh","doi":"10.1007/s11934-025-01302-3","DOIUrl":"10.1007/s11934-025-01302-3","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Erectile dysfunction (ED) is a highly prevalent disease, affecting over 24% of men in the United States. Factors such as privacy and accessibility often act as barriers to care for patients. With the emergence of telemedicine, direct-to-consumer (DTC) platforms have become popular avenues for patients to seek care. These platforms are especially attractive to patients with ED due to their promises of providing discrete and convenient care. Phosphodiesterase type 5 (PDE5) inhibitors remain the most commonly prescribed therapy for ED. This review evaluates recent literature over the past five years to better understand the economics of PDE5 inhibitors offered through DTC platforms.</p><p><strong>Recent findings: </strong>Studies have shown that while DTC companies offer convenience, these medications are offered at a significantly marked up price compared to more conventional means, such as an in-person clinical visit and brick and mortar pharmacies. While DTC platforms offer a promising model for improving access to ED care, their economic trade-offs and clinical limitations must be considered. Ongoing research and transparent pricing are needed to ensure that all patients with ED can make informed choices that best meet their clinical and economic needs.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"69"},"PeriodicalIF":3.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12575493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408444","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}