International Journal of Urology最新文献

Decision Curve Analysis-Based Risk-Adaptive Strategy for Individualizing Cystoscopy Decisions in Patients With Primary Microscopic Hematuria. 基于决策曲线分析的风险适应策略对原发性显微镜下血尿患者进行个体化膀胱镜检查决策。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-18 DOI: 10.1111/iju.70152

Cagri Akpinar, Samet Erkartal, Turker Soydas, Doruk Demirel, Ahmet Emin Dogan, Adem Sanci, Ahmet Nihat Karakoyunlu

{"title":"Decision Curve Analysis-Based Risk-Adaptive Strategy for Individualizing Cystoscopy Decisions in Patients With Primary Microscopic Hematuria.","authors":"Cagri Akpinar, Samet Erkartal, Turker Soydas, Doruk Demirel, Ahmet Emin Dogan, Adem Sanci, Ahmet Nihat Karakoyunlu","doi":"10.1111/iju.70152","DOIUrl":"https://doi.org/10.1111/iju.70152","url":null,"abstract":"Objectives: To develop a decision curve analysis (DCA)-based risk-adapted strategy that includes risk factors and aids clinical decision-making to avoid unnecessary cystoscopy in patients with primary microscopic hematuria (MH).Material and methods: Data of 846 consecutive patients who underwent cystoscopy due to microscopic hematuria between September 2022 and April 2024 at a single center were prospectively collected and retrospectively analyzed. MH was defined as 3 or more erythrocytes per magnification in urine analysis. Strategies were developed according to the results of univariate and multivariate analyses. For each strategy, avoided unnecessary cystoscopy and missed bladder tumor ratios were detected. DCA was used to statistically compare the net benefits of each strategy.Results: Tumors were detected in the bladder in 66 patients (7.8%). Multivariate analysis identified smoking status, pack-years of smoking, and advanced age as risk factors for tumor detection, while concurrent lower urinary tract symptoms (LUTS) and a history of recurrent urinary tract infections (UTI)/prostatitis were associated with a decreased risk. DCA showed that the highest net benefit for detecting tumors in MH was achieved through cystoscopy in patients with > 10 pack-years of smoking and/or no irritative LUTS. The next best strategies involved > 10 pack-years of smoking and/or a history of macroscopic hematuria, and active smoking and/or no irritative LUTS, respectively.Conclusion: DCA-based risk-adapted strategies aid in clinical decision-making and reduce unnecessary interventions in patients scheduled for cystoscopy due to MH. These strategies can guide patients and clinicians regarding the advantages of avoiding cystoscopy and appropriate patient preferences.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ceratonia siliqua Protects Testicular Tissue in Ischemia/Reperfusion Injury: Limitations and Future Directions. 水蛭对睾丸缺血/再灌注损伤的保护作用：局限性和未来发展方向。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-16 DOI: 10.1111/iju.70155

Yitong Weng, Bing Ji

引用次数: 0

Editorial Comment to "VIRMA Accelerates the Tumorigenesis of Prostate Cancer via Regulating the m6A Modification of NSMCE2 to Eliminate the Generation of Reactive Oxygen Species". “VIRMA通过调节NSMCE2的m6A修饰来消除活性氧的产生，从而加速前列腺癌的肿瘤发生”的社论评论。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-16 DOI: 10.1111/iju.70150

Ryuta Watanabe

引用次数: 0

Open Versus Robotic Radical Cystectomy With Intracorporeal Neobladder: A Decade-Long Single-Surgeon Experience. 开放与机器人根治性膀胱切除术与体内新膀胱：长达十年的单一外科医生的经验。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-16 DOI: 10.1111/iju.70139

Neeraja Tillu, Zachary Dovey, Manish Choudhary, Arjun Venkatesh, Ahmed Eraky, Miriam Campistol, Maida Bada, Arshia Rangchi, Mohammed Jabo, Carmen Mir, Tommasangelo Petitti, Osama Zaytoun, Maurizio Buscarini

{"title":"Open Versus Robotic Radical Cystectomy With Intracorporeal Neobladder: A Decade-Long Single-Surgeon Experience.","authors":"Neeraja Tillu, Zachary Dovey, Manish Choudhary, Arjun Venkatesh, Ahmed Eraky, Miriam Campistol, Maida Bada, Arshia Rangchi, Mohammed Jabo, Carmen Mir, Tommasangelo Petitti, Osama Zaytoun, Maurizio Buscarini","doi":"10.1111/iju.70139","DOIUrl":"https://doi.org/10.1111/iju.70139","url":null,"abstract":"Introduction: This single-surgeon, long-term study aims to evaluate open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) with Studer urinary diversion in bladder cancer patients in terms of perioperative, oncological, and functional outcomes.Methods: This was a single-center, single-surgeon study analyzing patients who underwent open versus robotic intracorporeal neobladder (RIN) from January 2009 to January 2020. We recorded baseline characteristics, perioperative variables, outcomes, including cancer-specific survival (CSS) and overall survival (OS), and functional outcomes.Results: The study included 454 patients (242 open, 212 robotic) with an overall follow-up of 120 months. The RIN group had significantly lower blood loss (p < 0.001), more unilateral nerve sparing (p = 0.008), and higher lymph node yield (p = 0.042). The number of 30-day readmissions favored RIN significantly (p = 0.041). Complication rates (major and minor) were similar between groups (p = 0.56 and 0.61, respectively). The RIN group had improved severe daytime continence (p = 0.03), though no significant difference was found in erectile function (p = 0.56). The robotic cohort showed improved 10-year CSS in T3 disease (68.3% vs. 50.5%, p = 0.04). The OS for the entire cohort was 66.5% for the robotic cohort and 61.6% for open at 10 years (p = 0.08).Conclusions: In this series, RIN had decreased blood loss, an increased lymph node yield, decreased rate of hospital readmissions, lesser hospital stay, and improved severe daytime continence compared to the open approach.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Publication Bias in Randomized Controlled Trials of Hypospadias Surgical Repair: A Systematic Review. 尿道下裂手术修复随机对照试验的发表偏倚：一项系统综述。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-16 DOI: 10.1111/iju.70153

Ebram Nainggolan, Irfan Wahyudi, Arry Rodjani, Gerhard Reinaldi Situmorang, Muhammad E H Chowdhury, Putu Angga Risky Raharja, Tariq Abbas

{"title":"Publication Bias in Randomized Controlled Trials of Hypospadias Surgical Repair: A Systematic Review.","authors":"Ebram Nainggolan, Irfan Wahyudi, Arry Rodjani, Gerhard Reinaldi Situmorang, Muhammad E H Chowdhury, Putu Angga Risky Raharja, Tariq Abbas","doi":"10.1111/iju.70153","DOIUrl":"https://doi.org/10.1111/iju.70153","url":null,"abstract":"Objectives: Hypospadias is a common congenital condition in males that has been subject to extensive research. However, publication bias can distort the scientific literature and impact clinical decision-making. This review evaluates publication bias in hypospadias research and emphasizes the need for balanced reporting to improve clinical practices and enhance patient care.Methods: A literature search was conducted using four public databases to identify peer-reviewed randomized controlled trials (RCT) of surgical interventions for hypospadias. The primary outcomes were success rate and complication rate. We assessed the publications using the Risk of Bias 2 (RoB-2) tool and evaluated the quality of evidence using the GRADE method. Data were collated and recalculated using RevMan version 5.4. Publication bias was evaluated using a funnel plot and Egger's test.Results: The study included 32 articles for detailed analysis. The standard of evidence varied, with 8 studies rated as low quality, 23 as moderate, and 1 as high. Most studies lacked details on randomization, allocation concealment, and blinding, thus raising bias concerns. The funnel plot revealed a symmetrical distribution, and Egger's test indicated mild evidence of publication bias (p = 0.055).Conclusions: This study found no significant publication bias in hypospadias research, indicating a balanced evidence base at present. However, future studies should monitor bias through longitudinal assessments, explore new methodologies to mitigate bias, and increase visibility and accessibility of results to ensure the reliability of research findings.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preliminary Report on the Efficacy and Safety of Triplet Therapy in Patients With Metastatic Hormone-Sensitive Prostate Cancer: YUSHIMA Study. 三联疗法治疗转移性激素敏感前列腺癌的疗效和安全性的初步报告：YUSHIMA研究。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-16 DOI: 10.1111/iju.70154

Yosuke Yasuda, Noboru Numao, Shunya Matsumoto, Takashi Tamiya, Yuki Nakamura, Hajime Tanaka, Soichiro Yoshida, Shuichiro Kobayashi, Ryoji Takazawa, Yoh Matsuoka, Junji Yonese, Yasuhisa Fujii

{"title":"Preliminary Report on the Efficacy and Safety of Triplet Therapy in Patients With Metastatic Hormone-Sensitive Prostate Cancer: YUSHIMA Study.","authors":"Yosuke Yasuda, Noboru Numao, Shunya Matsumoto, Takashi Tamiya, Yuki Nakamura, Hajime Tanaka, Soichiro Yoshida, Shuichiro Kobayashi, Ryoji Takazawa, Yoh Matsuoka, Junji Yonese, Yasuhisa Fujii","doi":"10.1111/iju.70154","DOIUrl":"https://doi.org/10.1111/iju.70154","url":null,"abstract":"Background: The phase 3 ARASENS and PEACE-1 studies demonstrated significant survival benefits from triplet therapy (androgen deprivation therapy [ADT] plus androgen receptor signaling inhibitor plus docetaxel) versus ADT plus docetaxel alone. We examined the efficacy and safety of triplet therapy using the prospective observational clinical study: YUSHIMA study database.Methods: We analyzed data on patients with metastatic hormone-sensitive prostate cancer (mHSPC) treated with triplet therapy extracted from the YUSHIMA study database. Deep and early prostate-specific antigen (PSA) response was defined as ≥ 90% PSA decline or PSA ≤ 0.2 ng/mL achievable at 3 months of treatment. Kaplan-Meier curves were used to assess overall survival (OS) and castration-resistant prostate cancer (CRPC)-free survival. Adverse events (AEs) were graded using Common Terminology Criteria for Adverse Events version 5.0.Results: Overall, 317 patients were enrolled in the YUSHIMA study from 2021 to 2025, of which 48 received triplet therapy. Organ metastases accounted for 25%. According to the CHAARTED and LATITUDE criteria, 77% and 73% of patients exhibited high-volume and high-risk disease, respectively. The 1-year OS and CRPC-free survival rates were 88% and 79%, respectively. Deep and early PSA response was achieved in 98%. In our cohort, grade 3-4 AEs appeared in 89% of cases, most of which were neutropenia. In 20% of cases, 6 courses of docetaxel could not be completed due to AEs.Conclusions: Triplet therapy was highly efficacious and tolerable in Japanese mHSPC patients. Although most patients experienced grade 3-4 neutropenia, no cases were fatal. The deep and early PSA response represents a satisfactory short-term result.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk Model for Lymph Node-Positive Prostate Cancer After Radical Prostatectomy. 根治性前列腺切除术后淋巴结阳性前列腺癌的风险模型。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-16 DOI: 10.1111/iju.70149

Kojiro Tashiro, Keiichiro Mori, Masaki Shiota, Wataru Fukuokaya, Dai Takamatsu, Yoshiyuki Matsui, Masashi Kato, Ryoichi Saito, Akira Yokomizo, Masakazu Tsutsumi, Yoshiyuki Yamamoto, Kohei Edamura, Makito Miyake, Shuichi Morizane, Takayuki Yoshino, Ryuji Matsumoto, Shintaro Narita, Hiroshi Kitamura, Masatoshi Eto, Takahiro Kimura

{"title":"Risk Model for Lymph Node-Positive Prostate Cancer After Radical Prostatectomy.","authors":"Kojiro Tashiro, Keiichiro Mori, Masaki Shiota, Wataru Fukuokaya, Dai Takamatsu, Yoshiyuki Matsui, Masashi Kato, Ryoichi Saito, Akira Yokomizo, Masakazu Tsutsumi, Yoshiyuki Yamamoto, Kohei Edamura, Makito Miyake, Shuichi Morizane, Takayuki Yoshino, Ryuji Matsumoto, Shintaro Narita, Hiroshi Kitamura, Masatoshi Eto, Takahiro Kimura","doi":"10.1111/iju.70149","DOIUrl":"https://doi.org/10.1111/iju.70149","url":null,"abstract":"Background: Post-radical prostatectomy (RP) lymph node positivity (pN1) is associated with disease progression. However, the optimal treatment strategy for pN1 patients has remained unclear. This study aimed to establish a risk model for predicting survival outcomes in these patients.Methods: We retrospectively studied 528 eligible patients with pN1 undergoing RP with pelvic lymph node dissection between 2006 and 2019 at 33 participant institutions in the Japanese Urologic Oncology Study Group. Metastasis-free survival (MFS) was used to evaluate for survival outcome. A least absolute shrinkage and selection operator (LASSO)-penalized, multivariate Cox regression model for MFS was used to evaluate patients for their risk factors and establish a risk model with an associated nomogram.Results: Grade group (GGs 4-5 vs. GGs 1-3: HR, 7.35; 95% confidence intervals (CI), 1.76-30.7; p = 0.006), pathological T-stage (pT3b or more vs. pT2 to pT3a: HR, 2.01; 95% CI, 0.93-4.34; p = 0.075), number of positive lymph nodes (HR, 2.03; 95% CI, 0.83-4.96; p = 0.044), and positive lymph node diameter (> 2 mm vs. ≤ 2 mm: HR, 2.03; 95% CI, 1.09-9.00; p = 0.034) were identified as independent prognostic factors for predicting 60-month MFS.Conclusions: This study explored prognostic factors for pN1 prostate cancer patients for predicting their MFS and identified a risk model involving a nomogram. Randomized controlled trials are necessary in patients with pN1 prostate cancer to elucidate optimal postoperative treatment indications and selection.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Comment on "Association Between Overactive Bladder and Sarcopenia in Older Adults: A Population-Based Cohort Study". 关于“老年人膀胱过度活动与肌肉减少症的关系：一项基于人群的队列研究”的评论。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-11 DOI: 10.1111/iju.70151

Hisae Nishii

引用次数: 0

Current Evidences and Future Perspectives in the Management of Metastatic Non-Clear Cell Renal Cell Carcinoma. 转移性非透明细胞肾细胞癌治疗的当前证据和未来展望。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-09 DOI: 10.1111/iju.70144

Shotaro Nakanishi, Junichi Inokuchi

{"title":"Current Evidences and Future Perspectives in the Management of Metastatic Non-Clear Cell Renal Cell Carcinoma.","authors":"Shotaro Nakanishi, Junichi Inokuchi","doi":"10.1111/iju.70144","DOIUrl":"https://doi.org/10.1111/iju.70144","url":null,"abstract":"Renal cell carcinoma is a heterogeneous disease with diverse phenotypes. Renal cell carcinoma classification is based on morphological and molecular characteristics and falls into 2 main categories: clear cell renal cell carcinoma and non-clear cell renal cell carcinoma. Clear cell renal cell carcinoma is the predominant subtype, accounting for approximately 70%-80%, while non-clear cell renal cell carcinoma constitutes 20%-30%. Non-clear cell renal cell carcinoma comprises multiple histologic types, each with distinct clinicopathologic features. The fifth edition of the World Health Organization classification of urinary and male genital tumors, published in 2022, introduced significant updates and revisions in kidney tumor classification. The new classification incorporated molecular biological factors into the existing framework and introduced additional tumor subtypes. Most clinical trials have excluded or included only small numbers of patients with non-clear cell renal cell carcinoma. Due to the scarcity of prospective studies focusing on this population, data on response rates and survival outcomes remain limited. However, recent evidence suggests the efficacy of combination therapy with immune checkpoint inhibitors and tyrosine kinase inhibitors in non-clear cell renal cell carcinoma. This review examines immunotherapy and tyrosine kinase inhibitor outcomes across non-clear cell renal cell carcinoma subtypes and highlights opportunities for enhanced care through novel therapies, biomarker-driven approaches, and more inclusive clinical trial designs.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinicopathological Characteristics of Upper Tract Urothelial Cancer With Loss of Immunohistochemical Expression of Mismatch Repair Proteins. 错配修复蛋白免疫组织化学表达缺失的上尿路上皮癌的临床病理特征。

IF 1.8 3区医学

International Journal of Urology Pub Date : 2025-06-09 DOI: 10.1111/iju.70146

Go Kobayashi, Tetsutaro Hayashi, Yohei Sekino, Kenichiro Ikeda, Hikaru Nakahara, Kohei Kobatake, Keisuke Goto, Daiki Taniyama, Kazuya Kuraoka, Shintaro Akabane, Hiroaki Niitsu, Takao Hinoi, Kazuhiro Sentani, Nobuyuki Hinata

{"title":"Clinicopathological Characteristics of Upper Tract Urothelial Cancer With Loss of Immunohistochemical Expression of Mismatch Repair Proteins.","authors":"Go Kobayashi, Tetsutaro Hayashi, Yohei Sekino, Kenichiro Ikeda, Hikaru Nakahara, Kohei Kobatake, Keisuke Goto, Daiki Taniyama, Kazuya Kuraoka, Shintaro Akabane, Hiroaki Niitsu, Takao Hinoi, Kazuhiro Sentani, Nobuyuki Hinata","doi":"10.1111/iju.70146","DOIUrl":"https://doi.org/10.1111/iju.70146","url":null,"abstract":"Objectives: Lynch syndrome (LS) is an inherited cancer predisposition caused by germline mutations in DNA mismatch repair (MMR) genes. Upper tract urothelial carcinoma (UTUC) is the third most common cancer associated with LS. In this study, we examined MMR protein expression in UTUC using immunohistochemistry to clarify the clinicopathological characteristics and prognostic significance of LS-associated UTUC.Methods: We analyzed the expression of MLH1, MSH2, MSH6, and PMS2 by immunohistochemistry in 118 cases of UTUC treated with radical nephroureterectomy. MMR deficiency was defined as tumors exhibiting less than 5% MMR protein expression. We conducted further investigations using public databases.Results: MMR deficiency was identified in 15 (13%) of the 118 UTUC cases. These cases were associated with younger age, papillary morphology, low grade, low stage, low neutrophil-to-lymphocyte ratio, high levels of CD8-positive tumor-infiltrating lymphocytes, and favorable prognosis. Similar findings were observed through in silico analysis. Public datasets revealed that tumor mutational burden in UTUC was significantly higher in MMR-mutated cases compared to MMR-normal cases. A waterfall plot showed a high frequency of FGFR3 mutation in MMR-mutated cases in UTUC. Bioinformatics analysis using RNA-Seq datasets showed that MMR-mutated UTUC was associated with enriched gene sets for MYC targets v1 and oxidative phosphorylation. Furthermore, gene expression levels of GALNT12 and FRMD3 emerged as potential predictors of MMR mutation in UTUC.Conclusions: These findings highlight the clinical value of evaluating MMR protein expression by immunohistochemistry, which could inform treatment strategies and surveillance protocols for UTUC patients.","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0