European urology focus最新文献

{"title":"Results of Stress Incontinence Surgery in Octogenarian Women.","authors":"Tufan Tarcan, Andrea Braga, Tamsin J Greenwell, Enrico Finazzi-Agro","doi":"10.1016/j.euf.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.007","url":null,"abstract":"<p><p>Stress urinary incontinence (SUI) is common among octogenarian women, often in association with significant comorbidities that can include functional and cognitive impairment. There is limited evidence in the literature on the efficacy and safety of current surgical options for treating SUI in octogenarians. The few studies available on this topic mainly focus on mid-urethral slings and reveal similar efficacy and safety profiles for octogenarian women in comparison to younger women. These studies are mostly retrospective, with small sample sizes and short follow-up. What data there are suggest that greater frailty, not older age, may be associated with complications in the elderly population (>65 yr), a finding that is not specific to octogenarians. Prospective studies with larger sample sizes and longer follow-up are needed to assess the safety and efficacy of the different surgical treatment options for SUI in octogenarians. PATIENT SUMMARY: This mini review discusses the results of surgery for treatment of stress urinary incontinence in women older than 80 years. The limited evidence available suggests that surgical treatments can be safely performed in well-selected octogenarian women after a careful preoperative assessment.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691178","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":"SATURN: A Multinational, Multicentre, Prospective Surgical Registry for Male Urinary Incontinence Surgery Across Europe with Planned 10-year Follow-up.","authors":"Nikesh Thiruchelvam, John Heesakkers, Rizwan Hamid, Frank Martens, Frank Van der Aa, Wim Witjes, Christien Caris, Joni Kats","doi":"10.1016/j.euf.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.004","url":null,"abstract":"<p><p>The SATURN registry captures data for 1090 parameters, including patient demographics, surgical techniques, and long-term postoperative outcomes of surgery for male stress urinary incontinence across Europe. Despite a high surgical revision rate, the AMS800 artificial urinary sphincter (AUS) was the commonest surgical procedure for male stress urinary incontinence and yielded the best improvements in symptom scores. Preliminary findings suggest that centre volume does not strongly influence complication rate or functional outcomes of AUS implantation.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673257","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":"Clinical Consultation Guide: A Patient-tailored Approach to Managing Overactive Bladder in Nursing Home Residents.","authors":"Omer Anis, Stacy H Jeong, Sandip P Vasavada","doi":"10.1016/j.euf.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.008","url":null,"abstract":"<p><p>Management of overactive bladder in nursing home residents requires a patient-specific approach that takes frailty and comorbidities into consideration. Tailored diagnostic and treatment strategies, including cautious use of medications and alternative therapies, can improve quality of life in this vulnerable population.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673030","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":"Same-day Outpatient Robotic Surgery in Urology.","authors":"Antony Pellegrino, Alberto Briganti, Simone Crivellaro","doi":"10.1016/j.euf.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.006","url":null,"abstract":"<p><p>Outpatient robotic urological surgery is safe and feasible for selected patients and can reduce the hospital length of stay and costs. Key factors include preoperative counseling, optimized perioperative care, and tailored patient selection, with outcomes comparable to those for inpatient procedures.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669509","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":"Engaging Patients in Clinical Trials on Kidney Stones: Lessons Learned.","authors":"Jonathan S Ellison, Gregory E Tasian","doi":"10.1016/j.euf.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.005","url":null,"abstract":"<p><p>Although kidney stone disease is one of the most common benign urologic diseases worldwide, there are significant knowledge gaps regarding care for these patients. Well-designed, high-impact clinical trials are essential to close these knowledge gaps. However, there are significant barriers for clinical trials in this setting, which include ensuring continued relevance for the study population, achieving requisite accrual, and disseminating evidence back to the communities of interest. Engaging patient and caregiver partners as co-collaborators in the research team can address many of these barriers by providing insight into study ideation, clinical trial design and outcome selection, and patient-centered analytic plans. This engagement can ensure that clinical trials are relevant to the patients and caregivers who will benefit most from the results. PATIENT SUMMARY: Patients and caregivers have unique experiences and can be key partners in research. Their views can improve the research process for kidney stone disease.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669507","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":"Laser Therapy for Female Stress Urinary Incontinence: Con.","authors":"Maurizio Serati, Andrea Braga","doi":"10.1016/j.euf.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.003","url":null,"abstract":"<p><p>Although initial data on laser therapy for the treatment of stress urinary incontinence (SUI) were encouraging, it now seems to be well established that the effectiveness of this modality for severe SUI is very low for older women and those who are overweight or obese.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630284","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":"Five-year Follow-up of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods-A Noninferiority Randomised Controlled Trial of Urodynamics.","authors":"Madeleine Clout, Amanda L Lewis, Madeleine Cochrane, Grace J Young, Paul Abrams, Peter S Blair, Christopher Chapple, Gordon T Taylor, Sian Noble, Tom Steuart-Feilding, Jodi Taylor, J Athene Lane, Marcus J Drake","doi":"10.1016/j.euf.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.euf.2025.02.004","url":null,"abstract":"<p><strong>Background and objective: </strong>Lower urinary tract symptoms (LUTS) are a key indication for surgery in older men. The Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM) study evaluated the diagnostic pathway for men considering surgery to treat LUTS and reported the outcomes at 18 mo. This long-term follow-up study reports the symptoms and rates of prostate surgery at 5 yr.</p><p><strong>Methods: </strong>UPSTREAM participants who had consented to long-term follow-up received postal questionnaires at 5 yr after randomisation (October 2019-December 2021). The primary outcome was the patient-reported International Prostate Symptom Score (IPSS, scale 0-35). Rates of surgery, derived from the National Health Service (NHS) England routine data, were a key secondary outcome. An intention-to-treat analytic approach was utilised.</p><p><strong>Key findings and limitations: </strong>At 5 yr, 211/427 (49.4%) participants in the intervention group and 204/393 (51.9%) in the routine care group completed the questionnaires, with routine data obtained for 801/820 (97.7%). The mean IPSS at 5 yr did not differ between randomised groups (adjusted difference 0.41, 95% confidence interval -1.10, 1.93), nor did the rates of surgery (0.96 [0.71, 1.28]). Urinary and sexual symptoms also showed no differences between the randomised groups. The main limitation is the reduced numbers of men in follow-up. In UPSTREAM, men were randomised to routine care diagnostic tests plus invasive urodynamics (intervention) or routine care only for LUTS. Treatment choice was made by the participants, advised by their clinicians.</p><p><strong>Conclusions and clinical implications: </strong>Five-year follow-up does not support the routine use of invasive urodynamics in reducing LUTS or rates of prostate surgery. Urodynamics should be used selectively in the evaluation of uncomplicated LUTS.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624092","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":"Suction Ureteral Access Sheaths for Renal Stone Treatment: Essential for Every Case: For.","authors":"Vineet Gauhar, Steffi Kar Kei Yuen, Daniele Castellani","doi":"10.1016/j.euf.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.002","url":null,"abstract":"<p><p>The use of a flexible and navigable suction ureteral sheath in retrograde intrarenal surgery is effective for improving 30-d stone-free rate, while minimizing infectious complications.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624093","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":"Targeting the Autonomic Nervous System for Treatment of Urinary Incontinence.","authors":"Guillermo Conde-Santos, Barbara Padilla-Fernández","doi":"10.1016/j.euf.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.euf.2025.02.015","url":null,"abstract":"<p><p>Urinary incontinence is a difficult condition that affects millions of people around the world. Recent research has opened the door to understanding the involvement of imbalance in the autonomic nervous system (ANS) as a cause of urge urinary incontinence (UUI) and has highlighted the therapeutic potential of targeting the sympathetic and parasympathetic pathways. This mini-review discusses current pharmacological and neuromodulation approaches that act on the ANS to restore bladder function. Future research should investigate the role of the ANS in bladder dysfunction and incontinence in more depth, and assess optimization of neuromodulation protocols and therapy combination to improve outcomes for patients with UUI. PATIENT SUMMARY: Our mini-review discusses dysfunction of the autonomic nervous system (ANS) as a possible cause of urge urinary incontinence. We describe treatments that could have an effect on incontinence by improving the balance of the ANS. Further research is needed to define the role of the ANS in tailoring treatment for individual patients.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604434","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":"Intrarenal Pressure During Ureteroscopy.","authors":"Emmeli Grøne Lykkegaard, Helene Jung","doi":"10.1016/j.euf.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.euf.2025.02.010","url":null,"abstract":"<p><p>Intrarenal pressure (IRP) increases during ureteroscopy because of irrigation and scope manipulation and typically exceeds physiological levels. Elevated IRP can cause intrarenal backflow (IRB), whereby irrigation fluid and urine flow backwards into the kidney structures, increasing the risk of infectious complications and sepsis. The irrigation rate, outflow, and tool size are important variables that can affect IRP and the risk of IRB, but IRB thresholds vary based on papillary morphology indicating pressure compliance differences among patients. Recent research has shed light on IRP and the potential clinical consequences of elevated IRP. A greater focus on reducing IRP during ureteroscopy is recommended. PATIENT SUMMARY: When a small telescope is used to inspect the urinary tract up to the kidney, pressure inside the kidney increases because irrigation fluid is used. High pressure can cause fluid and urine to flow backwards into the kidney, which could lead to infection. The irrigation flow rate, drainage efficiency, size of the tools used, and the structure of a patient's kidney tissue can influence the pressure and the risk of backflow. Studies have shown the importance of controlling this pressure to reduce complications.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585080","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}