International Journal of Urology最新文献

{"title":"Impact of Enhanced Recovery After Surgery Protocol on Perioperative Quality of Life in Robot-Assisted Radical Prostatectomy: A Single-Center Prospective Cohort Study.","authors":"Masaki Nakamura, Yasuko Muraki, Yumi Yamada, Satoko Matsumoto, Yuko Tsuji, Ibuki Tsuru, Akihiro Ono, Junko Watanabe, Keiko Okabe, Masanori Kashiwagi, Akie Kiuchi, Taro Izumi, Ryo Amakawa, Yasushi Inoue, Tadashi Yoshimatsu, Akira Fukuda, Michio Hayashi, Takami Komatsu, Teppei Morikawa, Shuji Kameyama, Haruki Kume, Yoshiyuki Shiga","doi":"10.1111/iju.70177","DOIUrl":"https://doi.org/10.1111/iju.70177","url":null,"abstract":"<p><strong>Objectives: </strong>Enhanced recovery after surgery is a comprehensive, multidisciplinary perioperative care program designed to minimize postoperative complications. Despite its widespread use in urological surgeries, the effect of enhanced recovery after surgery on the quality of life during robot-assisted radical prostatectomy remains unclear. We performed a prospective cohort study to elucidate the effect of enhanced recovery following robot-assisted radical prostatectomy on patients' quality of life.</p><p><strong>Methods: </strong>This prospective cohort study included 150 consecutive patients who underwent robot-assisted radical prostatectomy at a single institution. A total of 133 patients were analyzed after excluding those with incomplete data. The patients were divided into two groups: 32 in the non-enhanced recovery group and 101 in the enhanced recovery group. To assess the quality of life, patients undergoing robot-assisted radical prostatectomy completed the Functional Assessment of Cancer Therapy-Prostate questionnaire 1 day before and 1 month after surgery.</p><p><strong>Results: </strong>Patient characteristics did not differ between the two groups. No significant differences were observed in the preoperative Functional Assessment of Cancer Therapy-Prostate scores between the groups. Perioperative changes in the physical well-being subscale for the non-enhanced recovery after surgery and enhanced recovery after surgery groups were -3.5 and -2.0, respectively (p = 0.0463). Furthermore, enhanced recovery after surgery was a significant predictor of a smaller perioperative decline in the Functional Assessment of Cancer Therapy-Prostate Physical Well-Being subscale score.</p><p><strong>Conclusion: </strong>Enhanced recovery after surgery helps to preserve physical well-being during robot-assisted radical prostatectomy.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608328","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}

{"title":"A Decrease in Longitudinal Length of Kidney is a Reliable Tool to Predict the Success of Pyeloplasty in Children.","authors":"Dogancan Dorucu, Kader Ada Dogan, Onur Can Ozkan, Cagri Akin Sekerci, Yiloren Tanidir, Tufan Tarcan, Selcuk Yucel","doi":"10.1111/iju.70175","DOIUrl":"https://doi.org/10.1111/iju.70175","url":null,"abstract":"<p><strong>Objectives: </strong>The renal pelvis anteroposterior diameter (RPAPD) is an important parameter used in the indication and follow-up of ureteropelvic junction obstruction (UPJO). We hypothesized that kidney dimensions, namely longitudinal length (LL) and transverse width (TW), may have an easier similar validity to RPAPD measurement in the diagnosis of UPJO and follow-up after pyeloplasty.</p><p><strong>Methods: </strong>Children who underwent pyeloplasty (January 2012-January 2024) were retrospectively evaluated. Exclusion criteria included megaureter, vesicoureteral reflux, urinary stones, duplicated systems, abnormal contralateral kidneys, secondary interventions, and incomplete data. The RPAPD, hydronephrosis grade, LL, and TW measured by ultrasound (US) before and 6 months after pyeloplasty were compared.</p><p><strong>Results: </strong>Forty-nine children (14 girls, 35 boys; age range: 6 months to 17 years) who underwent pyeloplasty were studied. A significant reduction in RPAPD (29 to 18 mm) and LL (99 to 95 mm) was observed in affected kidneys 6 months after pyeloplasty compared to preoperative US measurements (p < 0.0001 and p = 0.005, respectively) but not in TW (p = 0.19). Similarly, the ratio of LL of the affected kidney to contralateral kidney (1.2 to 1.12 mm) significantly decreased after pyeloplasty (p = 0.026) but not the ratio of TW (p = 0.357). A positive correlation between RPAPD and LL is revealed (correlation coefficient = 0.619, p < 0.001).</p><p><strong>Conclusions: </strong>The present study indicates that LL was elevated in affected kidneys compared to contralaterals and significantly decreases after pyeloplasty. We suppose that the decrease in LL may be an alternative, straightforward, and reliable measurement to assist in the follow-up after pyeloplasty.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608327","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}

{"title":"Editorial Comment From Dr. Miyake to Effects of Response to First-Line Chemotherapy Predicts Response to Maintenance Avelumab Therapy in Japanese Patients With Advanced Urothelial Carcinoma.","authors":"Makito Miyake","doi":"10.1111/iju.70174","DOIUrl":"https://doi.org/10.1111/iju.70174","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600360","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}

{"title":"Editorial Comment Regarding \"Initial Experience of Robot-Assisted Nephrectomy and Nephroureterectomy Using the Novel Saroa Surgical System\".","authors":"Yutaro Sasaki, Junya Furukawa","doi":"10.1111/iju.70180","DOIUrl":"https://doi.org/10.1111/iju.70180","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591221","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}

{"title":"Efficacy of Metastasectomy for Metastatic Bladder Cancer: A Systematic Review and Meta-Analysis.","authors":"Junjie Ji, Fengju Guan, Lijiang Sun, Guiming Zhang","doi":"10.1111/iju.70176","DOIUrl":"https://doi.org/10.1111/iju.70176","url":null,"abstract":"<p><strong>Objectives: </strong>It has been proposed that metastasectomy may cure some patients with a single metastasis. Hence, we considered it necessary to clarify the role of metastasectomy for metastatic bladder cancer (BCa).</p><p><strong>Methods: </strong>We conducted a systematic review of published reports on the efficacy of metastasectomy for different sites of BCa metastasis. We searched English articles published before 7 June 2025 in three electronic databases: PubMed, Embase, and Cochrane Library. We then extracted authors, year of publication, country in which the study was conducted, study institution, study design, survival analysis, months of follow-up, size of study cohort, treatment, hazard ratios (HR) with 95% confidence interval (CI), and source of HR. The Newcastle-Ottawa Scale was used to analyze the risk and quality of included studies. All procedures were performed according to the PRISMA guidelines. A meta-analysis was performed on studies with sufficient survival data to analyze. Overall survival was analyzed to clarify the efficacy of metastasectomy for metastatic BCa.</p><p><strong>Results: </strong>Our meta-analysis identified 8 of 7877 articles published from 1992 to 2024 that met our criteria. These articles encompassed 15 139 patients in all, which showed that patients who underwent metastasectomy had better overall survivals (OS) than did those who only had non-surgical treatment (HR = 0.46, 95% CI 0.27-0.79, I² = 64.3%). Additionally, we found a positive association between OS and metastasectomy in patients with brain metastases (HR = 0.49, 95% CI 0.34-0.70, I² = 49.7%).</p><p><strong>Conclusions: </strong>We found a positive association between metastasectomy and OS in patients with metastatic BCa, especially those with brain metastases. Metastasectomy should be considered an adequate approach in BCa, when feasible.</p><p><strong>Trial registration: </strong>PROSPERO number: CRD42021234305.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591222","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}

{"title":"Current Progress in Kidney Xenotransplantation: Time to Proceed to Clinical Trials.","authors":"Takayuki Hirose, Kiyohiko Hotta, Tatsuo Kawai","doi":"10.1111/iju.70173","DOIUrl":"https://doi.org/10.1111/iju.70173","url":null,"abstract":"<p><p>Kidney transplantation is the ideal treatment for end-stage kidney disease, but the shortage of donors limits its clinical implementation. Although xenotransplantation, particularly from pigs, is a promising approach to address the donor shortage, significant challenges, such as immune rejection and disease transmission, exist. However, recent advances in gene-editing technology as well as development of novel immunosuppressive drugs have significantly improved xenotransplant outcomes in nonhuman primates. Recent studies on xenotransplantation using decedent recipients have provided novel insights into human immune responses to porcine xenografts, despite the limited observation time in these recipients. Building upon these preclinical studies, four cases of clinical kidney xenotransplantation have recently been performed under a \"expanded access authorization.\" Understanding immunological responses, as well as various physiological discrepancies between human and porcine kidney function, must be enhanced before xenotransplantation can become a viable clinical solution to organ shortages. This review summarizes the current progress of kidney xenotransplantation in nonhuman primate models, decedent models, and clinical cases.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591220","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}

{"title":"E-PASS Scoring System in Predicting Postoperative Complications After Penile Prosthesis Implantation.","authors":"Kursat Kucuker, Alper Simsek, Mesut Berkan Duran, Mehmet Kirdar, Burak Saglam, Oguz Celik, Caner Ozdemir, Yusuf Ozlulerden, Sinan Celen","doi":"10.1111/iju.70165","DOIUrl":"https://doi.org/10.1111/iju.70165","url":null,"abstract":"<p><strong>Objectives: </strong>Complications related to penile prosthesis implantation surgery (PPI) can be categorized as infectious, non-infectious organ/tissue damage, device failure, and patient/partner dissatisfaction. However, no scoring system has been established to assess both preoperative physical status and intraoperative risk factors. The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score was originally developed to estimate postoperative complication risk in gastrointestinal surgeries. It incorporates age, severe cardiac/pulmonary disease, diabetes mellitus, performance status index, American Society of Anesthesiologists (ASA) classification, blood loss, body weight, operative time, and skin incision length. This study aims to evaluate the feasibility of the E-PASS scoring system in predicting postoperative complications following PPI.</p><p><strong>Methods: </strong>In this single-center retrospective study, data of 56 patients who underwent PPI between 2015 and 2024 were analyzed. Demographics, preoperative physical condition parameters, and intraoperative risk factors were recorded. E-PASS score and sub-scores were calculated.</p><p><strong>Results: </strong>Postoperative complications occurred in 17 patients (30.4%). Patients with complications had higher performance scores, ASA scores, prior pelvic/penile/urethral surgeries, prior PPI history, and higher E-PASS scores (preoperative risk score, surgical stress score, and comprehensive risk score [CRS]). A CRS cut-off value of -0.1238 predicted complications (AUC = 0.75; 95% CI 0.62-0.88; p < 0.003). CRS above the cut-off was associated with a 16.2-fold increase in complication risk.</p><p><strong>Conclusions: </strong>The E-PASS scoring system appears to be a reliable tool for predicting postoperative complications in patients undergoing PPI by incorporating both preoperative physical condition and intraoperative risk factors.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591223","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}

{"title":"External Validation on a Japanese Cohort of a Computer-Aided Diagnosis System Aimed at Characterizing ISUP ≥ 2 Prostate Cancers at Multiparametric MRI.","authors":"Raphael Escande, Tristan Jaouen, Christelle Gonindard-Melodelima, Sébastien Crouzet, Satoshi Kuroda, Rémi Souchon, Olivier Rouvière, Sunao Shoji","doi":"10.1111/iju.70161","DOIUrl":"https://doi.org/10.1111/iju.70161","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the generalizability of a computer-aided diagnosis (CADx) system based on the apparent diffusion coefficient (ADC) and wash-in rate, and trained on a French population to diagnose International Society of Urological Pathology ≥ 2 prostate cancer on multiparametric MRI.</p><p><strong>Methods: </strong>Sixty-eight consecutive patients who underwent radical prostatectomy at a single Japanese institution were retrospectively included. Pre-prostatectomy MRIs were reviewed by an experienced radiologist who assigned to suspicious lesions a Prostate Imaging-Reporting and Data System version 2.1 (PI-RADSv2.1) score and delineated them. The CADx score was computed from these regions-of-interest. Using prostatectomy whole-mounts as reference, the CADx and PI-RADSv2.1 scores were compared at the lesion level using areas under the receiver operating characteristic curves (AUC), and sensitivities and specificities obtained with predefined thresholds.</p><p><strong>Results: </strong>In PZ, AUCs were 80% (95% confidence interval [95% CI]: 71-90) for the CADx score and 80% (95% CI: 71-89; p = 0.886) for the PI-RADSv2.1score; in TZ, AUCs were 79% (95% CI: 66-90) for the CADx score and 93% (95% CI: 82-96; p = 0.051) for the PI-RADSv2.1 score. The CADx diagnostic thresholds that provided sensitivities of 86%-91% and specificities of 64%-75% in French test cohorts yielded sensitivities of 60% (95% CI: 38-83) in PZ and 42% (95% CI: 20-71) in TZ, with specificities of 95% (95% CI: 86-100) and 92% (95% CI: 73-100), respectively. This shift may be attributed to higher ADC values and lower dynamic contrast-enhanced temporal resolution in the test cohort.</p><p><strong>Conclusion: </strong>The CADx obtained good overall results in this external cohort. However, predefined diagnostic thresholds provided lower sensitivities and higher specificities than expected.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575461","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}

{"title":"Highly Complete Follow-Up Data Are Necessary to Ascertain the Actual Complication Rate in Orchidopexy for Undescended Testes.","authors":"Mick Uijldert, Luitzen A Groen, Keetje L De Mooij, Michiel J S Oosterveld, Harrie P Beerlage, Tom P V M De Jong, Rogier P J Schroeder","doi":"10.1111/iju.70168","DOIUrl":"https://doi.org/10.1111/iju.70168","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess orchidopexy outcomes in a tertiary pediatric urology center.</p><p><strong>Methods: </strong>A retrospective review of orchidopexies at our institution initially showed a 20% follow-up loss. To ensure more reliable outcomes, patients and parents were actively contacted and encouraged to attend follow-up visits 6 months post-surgery, reducing follow-up loss and enhancing the accuracy of our data.</p><p><strong>Results: </strong>Two hundred eleven patients with 254 testicular units were included, with only five patients lost to follow-up due to relocation, yielding a follow-up rate of 98%. The median follow-up time was 7 months. Of 206 inguinal orchidopexies, three were atrophied, and three had an inguinal position. Among 25 patients who underwent a (staged) laparoscopic procedure for abdominal testis, four were found to be atrophied. Of the 18 redo orchidopexies, one testis atrophied. One patient suffered a severe complication, Fournier's gangrene, due to streptococcus infection with uneventful healing after multiple surgeries.</p><p><strong>Conclusions: </strong>In a tertiary setting with a high follow-up percentage and orchidopexy performed or supervised by a fellowship-trained pediatric urologist, the success rate of standard orchidopexy was 97%, for redo orchidopexy 94%, and for laparoscopic (staged) procedures 80%. The reported outcomes can be used in more accurate patient/parental counseling in daily clinical practice and guidelines.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560088","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}

{"title":"Performance of the Transvaginal Mesh Surgery TVM-UPB Compared to the Laparoscopic Sacrocolpopexy Using a Polytetrafluoroethylene Mesh ORIHIME for Advanced Anterior Vaginal Prolapse.","authors":"Kazunobu Yagi, Masami Takeyama, Yukiko Doi, Tomoko Kuwata, Hiromi Kashihara, Chikako Kato, Masaki Watanabe","doi":"10.1111/iju.70169","DOIUrl":"https://doi.org/10.1111/iju.70169","url":null,"abstract":"<p><strong>Objectives: </strong>In the up-hold transvaginal mesh (TVM-UP) procedure, the barbs are shaped like arrowheads to prevent the mesh from slipping off the sacrospinous ligament. This modified procedure is termed TVM-UPB. This study examines the efficacy and safety of TVM-UPB surgery using polytetrafluoroethylene (PTFE) mesh ORIHIME for advanced anterior vaginal prolapse compared with laparoscopic sacrocolpopexy (LSC).</p><p><strong>Methods: </strong>A cohort study was conducted involving patients who underwent TVM-UPB surgery and LSC with ORIHIME for Pelvic Organ Prolapse Quantification of stage III or IV anterior vaginal prolapse between January 2022 and August 2023. The primary outcome was the recurrence rate in the operated compartment. The secondary outcomes included recurrence in the other pelvic compartments and risk factors for recurrence in the operated compartment.</p><p><strong>Results: </strong>Ninety-five patients underwent TVM-UPB, and 104 underwent LSC surgery during the study period. In a propensity-matched analysis of 199 patients, recurrence in the operated compartment was lower in the TVM-UPB group than in the LSC group. There was no significant difference in recurrence rates in the other compartments between the TVM-UPB and LSC groups. Age < 70 was associated with a higher risk of recurrence in the operated compartments (adjusted odds ratio: 6.32), while a preoperative Ba point score ≥ 2.5 was also associated with a higher risk of recurrence (adjusted odds ratio: 4.49).</p><p><strong>Conclusions: </strong>The recurrence rate in the operated compartment after TVM-UPB for advanced anterior vaginal prolapse was 3.2%. TVM-UPB using ORIHIME may be an effective surgical option for treating anterior vaginal prolapse.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560091","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}