International Journal of Urology最新文献

{"title":"Comorbid Diabetes Mellitus Contributes to Residual Overactive Bladder After Transurethral Surgery for Benign Prostatic Hyperplasia.","authors":"Koji Miki, Keisuke Kiba, Daisuke Maenosono, Yasunori Akashi, Mamoru Hashimoto, Yutaka Yamamoto, Kazutoshi Fujita, Akihide Hirayama","doi":"10.1111/iju.70080","DOIUrl":"https://doi.org/10.1111/iju.70080","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the factors associated with residual overactive bladder after transurethral surgery for benign prostatic hyperplasia.</p><p><strong>Methods: </strong>This study retrospectively analyzed male patients aged 50 years or older who underwent transurethral surgery for benign prostatic hyperplasia with overactive bladder between January 2014 and December 2022. The subjects were divided into poor and good responder groups based on the presence of overactive bladder after surgery. Preoperative background factors, the International Prostate Symptom Score, Overactive Bladder Symptom Score, free uroflowmetry, pressure flow study, and subjective and objective findings at 3, 6, and 12 months after surgery were compared between the two groups. Furthermore, multivariate analysis was performed to identify risk factors associated with residual overactive bladder after surgery.</p><p><strong>Results: </strong>Sixty-seven patients met the inclusion criteria. Among them, 18 and 49 patients were categorized as poor and good responders, respectively. Compared with the good responders, the poor responders had a significantly higher prevalence of metabolic syndrome, particularly waist circumference ≥ 85 cm and history of diabetes mellitus treatment. In addition, the poor responders had a higher preoperative maximum flow rate and lower bladder outlet obstruction index in the pressure flow study compared with the good responders. Multivariate analysis identified the history of diabetes treatment and the lower bladder outlet obstruction index as predictive factors for residual overactive bladder after surgery for benign prostatic hyperplasia.</p><p><strong>Conclusion: </strong>Our findings may improve the prediction of residual overactive bladder after surgery for benign prostatic hyperplasia.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982722","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":"The Effectiveness and Safety Profile of Nivolumab-Plus-Ipilimumab in Previously Untreated Japanese Patients With Advanced or Metastatic Renal Cell Carcinoma (J-ENCORE Study).","authors":"Koshiro Nishimoto, Go Kimura, Tomokazu Sazuka, Shuzo Hamamoto, Masahiro Nozawa, Kazuyuki Numakura, Atsushi Mizokami, Tsunenori Kondo, Sei Naito, Takashige Abe, Kojiro Ohba, Masayoshi Nagata, Shunta Onodera, Hiroaki Ito, Hirotsugu Uemura","doi":"10.1111/iju.70076","DOIUrl":"https://doi.org/10.1111/iju.70076","url":null,"abstract":"<p><strong>Objectives: </strong>Combination therapy of nivolumab-plus-ipilimumab has been approved for advanced or metastatic renal cell carcinoma in Japan, but large-scale clinical data targeting Japanese patients is limited. To evaluate the early outcomes and factors related to early progression and response.</p><p><strong>Methods: </strong>J-ENCORE is an ongoing multicenter, prospective, observational study of the effectiveness and safety of nivolumab-plus-ipilimumab for patients in Japan with advanced or metastatic renal cell carcinoma. The objective response rate, duration of response, progression-free survival, overall survival, incidence of adverse events, and factors related to early progression within 3 months, and response were assessed.</p><p><strong>Results: </strong>We included 274 patients (median age: 68 years, 24.8% aged ≥ 75 years, 78.8% male). The median follow-up was 23.4 months. The objective response rate was 36.8%. Among responders, 63.3% had progression-free survival > 12 months. The median progression-free survival was 9.9 months; the 12-month overall survival was 76.3%. Of the patients, 77.0% experienced treatment-related adverse events, 42.3% experienced grade 3-4 events, and 1.1% experienced treatment-related death. Early progression was associated with female sex, poor risk status, liver metastasis, high baseline C-reactive protein levels, and high neutrophil-to-lymphocyte ratios. Responders were less likely to have bone metastases. Limitations include the observational nature of the study and a relatively short follow-up period.</p><p><strong>Conclusions: </strong>This is the first prospective, real-world study to demonstrate the effectiveness and safety of nivolumab-plus-ipilimumab in Japan, with the results comparable to those of CheckMate 214. These findings support the use of nivolumab-plus-ipilimumab, although further studies with longer follow-up on nivolumab-plus-ipilimumab are needed.</p><p><strong>Trail registration: </strong>ClinicalTrials.gov identifier: NCT04043975; University Hospital Medical Information Network-Clinical Trial Registration: UMIN000036772.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012025","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":"Clinical Predictors of Fluoroquinolone-Resistant Escherichia coli in Transrectal Ultrasound-Guided Prostate Biopsy: Insights for Tailored Prophylaxis.","authors":"Takatoshi Somoto, Takanobu Utsumi, Naoki Ishitsuka, Takahide Noro, Yuta Suzuki, Shota Iijima, Yuka Sugizaki, Ryo Oka, Takumi Endo, Naoto Kamiya, Naomi Shimizu, Nobuyuki Hiruta, Hiroyoshi Suzuki","doi":"10.1111/iju.70082","DOIUrl":"https://doi.org/10.1111/iju.70082","url":null,"abstract":"<p><strong>Objectives: </strong>To identify clinical predictors of fluoroquinolone-resistant Escherichia coli colonization and evaluate their usefulness in guiding personalized antibiotic prophylaxis for patients undergoing transrectal ultrasound-guided prostate biopsy.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 539 patients who underwent biopsy between January 2015 and March 2023 at a high-volume referral center. Clinical data, including demographic, biochemical, and pathological parameters, were extracted. Patients were stratified into high- and low-risk groups based on the Japanese Urological Association's risk classification. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of fluoroquinolone-resistant E. coli.</p><p><strong>Results: </strong>Fluoroquinolone-resistant E. coli was detected in 17.1% of patients. The prevalence increased significantly over time, from 14.1% in the earlier period (2015-2019) to 20.9% in the later period (2019-2023) (p = 0.04). Multivariate analysis identified elevated C-reactive protein greater than 0.09 mg/dL and the use of steroid or immunosuppressive therapy as independent predictors of fluoroquinolone-resistant E. coli. In high-risk patients, elevated HbA1c greater than 5.9% was also a significant predictor. Notably, patients with fluoroquinolone-resistant flora had significantly lower rates of prostate cancer detection, particularly among low-risk individuals (52.1% vs. 75.7%, p < 0.01).</p><p><strong>Conclusions: </strong>Elevated C-reactive protein and immunosuppressive therapy are strong clinical predictors of fluoroquinolone-resistant E. coli colonization. These factors should be integrated into pre-biopsy assessment to guide selective rectal swab testing and tailor prophylactic strategies, thereby enhancing patient safety and reducing antibiotic resistance.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009334","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 to “The Effect of Adipose Tissue Mesenchymal Stem Cells and Melatonin in a Rat Model of Renal Ischemia Reperfusion Injury”","authors":"Yuki Maruyama","doi":"10.1111/iju.70084","DOIUrl":"10.1111/iju.70084","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"888-889"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982706","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":"Geriatric Nutritional Risk Index Predicts Postoperative Complications in Elderly Patients Undergoing Robot-Assisted Radical Cystectomy.","authors":"Kyotaro Fukuta, Kei Daizumoto, Yutaro Sasaki, Kazuyoshi Izumi, Fumiya Kadoriku, Seiya Utsunomiya, Keito Shiozaki, Takeshi Nakashima, Tomoya Fukawa, Ryoichi Nakanishi, Hirofumi Izaki, Masayuki Takahashi, Junya Furukawa","doi":"10.1111/iju.70070","DOIUrl":"https://doi.org/10.1111/iju.70070","url":null,"abstract":"<p><strong>Objective: </strong>Malnutrition is a common condition among elderly cancer patients. The Geriatric Nutritional Risk Index (GNRI) is a simple screening tool used to predict the risk of postoperative complications in patients undergoing radical cystectomy. This study aimed to evaluate the effectiveness of preoperative GNRI as a marker for predicting 90-day postoperative complications in elderly patients undergoing robot-assisted radical cystectomy (RARC).</p><p><strong>Methods: </strong>We retrospectively evaluated 385 patients who underwent RARC at four affiliated institutes of Tokushima University between 2014 and 2023. Patient background characteristics, pathological findings, and 90-day postoperative complications were analyzed. Preoperative GNRI was calculated using serum albumin and body mass index, with an abnormal nutritional status defined as GNRI < 92.</p><p><strong>Results: </strong>A total of 166 patients aged ≥ 75 years who underwent RARC were included in the study. Among these, 26 patients (15.7%) had an abnormal GNRI. Eighty-four patients (50.6%) experienced complications within 90 days postoperatively, including 29 patients (17.5%) with major complications (Clavien-Dindo classification ≥ 3). The 90-day postoperative mortality rate was 3.0% (five patients). Patients with an abnormal GNRI had a significantly higher rate of 90-day postoperative complications (p < 0.001). Multivariable logistic regression analysis identified abnormal GNRI as a significant predictor of 90-day postoperative complications (odds ratio: 9.963; 95% confidence interval: 2.125-46.718; p = 0.004).</p><p><strong>Conclusions: </strong>Poor nutritional status is associated with a higher rate of 90-day postoperative complications in elderly patients undergoing RARC. Preoperative GNRI may be a useful tool for assessing the risk of complications in this patient population.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971261","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":"Comments on \"The Effect of Neoadjuvant Chemotherapy on Survival Outcomes in Patients With Variant Histologies Who Underwent Radical Cystectomy With Precystectomy Diagnostic Accuracy: A Multicenter Study of the Turkish Urooncology Association\".","authors":"Türker Soydas","doi":"10.1111/iju.70078","DOIUrl":"https://doi.org/10.1111/iju.70078","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015608","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":"Reply to the Letter to the Editor “Testosterone Recovery and Health-Related Quality of Life After Short-Term Androgen Deprivation Therapy Combined With Low-Dose-Rate Brachytherapy: Limitations and Future Directions”","authors":"Kenta Onishi,&nbsp;Nobumichi Tanaka","doi":"10.1111/iju.70077","DOIUrl":"10.1111/iju.70077","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 6","pages":"772-773"},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023618","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":"Development, Validation, and Clinical Utility of a Nomogram for Urological Tumors: How to Build the Best Predictive Model.","authors":"Takanobu Utsumi, Naoki Ishitsuka, Takahide Noro, Yuta Suzuki, Shota Iijima, Yuka Sugizaki, Takatoshi Somoto, Ryo Oka, Takumi Endo, Naoto Kamiya, Hiroyoshi Suzuki","doi":"10.1111/iju.70075","DOIUrl":"https://doi.org/10.1111/iju.70075","url":null,"abstract":"<p><p>Nomograms are increasingly recognized as indispensable clinical prediction tools, offering individualized risk estimates through interpretable and visually intuitive formats. Their integration into urologic oncology has significantly advanced precision medicine by enabling refined risk stratification for patients with urological malignancies. This review provides a concise yet comprehensive overview of the development, clinical application, and future prospects of nomograms in urologic oncology. We first outline the essential methodological framework for constructing valid prediction models, including outcome definition, predictor selection, model building, and statistical evaluation using discrimination and calibration metrics. Internal validation techniques such as cross-validation and bootstrapping are highlighted as safeguards against overfitting, while external validation is emphasized to ensure generalizability across diverse clinical contexts. Twelve representative nomograms are examined, classified by display type and implementation format, to illustrate their clinical relevance and limitations. While regression-based models remain widely used, emerging approaches incorporating artificial intelligence and machine learning offer enhanced predictive accuracy but pose challenges in interpretability and integration into electronic health records. Interactive decision-support tools are also gaining prominence, promoting real-time, patient-centered care. Despite existing limitations, such as static outputs, dependence on retrospective data, and inconsistent methodological standards, nomograms continue to facilitate precise and evidence-based decision-making. Looking ahead, future models must prioritize transparency, dynamic updating, multimodal data integration, and adherence to established reporting guidelines. Through rigorous development and thoughtful implementation, nomograms will remain pivotal instruments in delivering personalized, high-quality care in urologic oncology.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983763","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 to Current Landscape of Urological Surgical Training: A Needs Assessment Survey in Japan","authors":"Tomokazu Kimura","doi":"10.1111/iju.70071","DOIUrl":"10.1111/iju.70071","url":null,"abstract":"&lt;p&gt;The training of highly skilled urologists has become a pressing priority in Japan's rapidly aging society. Japanese urologists perform both surgical and medical treatments, but the transmission of surgical skills—especially for highly invasive procedures—is critical. This study provides timely insights into urological surgical training across all three medical universities in Hokkaido, a vast and diverse region of Japan, making a significant contribution to surgical education. As the traditional “See one, Do one, Teach one” approach is increasingly replaced by competency-based training models, the authors conducted a comprehensive survey of trainees and instructors across multiple institutions to assess training practices and perceived educational disparities [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A key strength of this study is its high survey response rate, which enhances data reliability and reflects the growing interest in structured surgical education. The study examines various aspects, including available training resources, on-the-job (OJT) and off-the-job (Off-JT) training methods, trainee assessment strategies, and differences in perception between trainees and instructors, offering a comprehensive overview of the current training landscape. The findings highlight both strengths and areas for improvement in Japan's urological training system. While OJT remains the primary method for skill acquisition, access to Off-JT resources—such as laparoscopic dry labs and Virtual Reality simulators for robotic-assisted surgery—is limited to only a few institutions. The study also discusses how infrastructure limitations and instructors' heavy workloads restrict surgical education. Furthermore, a notable gap exists between trainees and instructors: trainees often feel their surgical training is insufficient, whereas instructors believe they are providing adequate guidance. Clinical education tends to be short-term and ad hoc, with limited stepwise assessment and evaluation, underscoring key challenges in the field.&lt;/p&gt;&lt;p&gt;Achieving surgical proficiency within a standard urology residency is difficult, necessitating lifelong learning. Academic societies, including the Japanese Medical Specialty Board and the Japanese Urological Association, should work toward developing integrated surgical training curricula and structured instructor development programs, as well as faculty development (FD) programs of clinical training instructors for medical residents. These efforts would enhance teaching capabilities, create educational opportunities, and improve the overall quality of urological training.&lt;/p&gt;&lt;p&gt;Surgical education organizations, such as the Association for Surgical Education [&lt;span&gt;2&lt;/span&gt;] in the U.S. and the Japanese Society for Surgical Education [&lt;span&gt;3&lt;/span&gt;], have gained attention in recent years. In Japan, the Surgeons as Educators [&lt;span&gt;4&lt;/span&gt;] offer FD programs and instructor training workshops focused on essential teaching skills. It is time f","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"821-822"},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Docetaxel Essential for Darolutamide-Based Metastatic Hormone-Sensitive Prostate Cancer Therapy?","authors":"Wei Chen, Soichiro Yoshida, Yasuhisa Fujii","doi":"10.1111/iju.70072","DOIUrl":"https://doi.org/10.1111/iju.70072","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017410","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}