Song Xu, Hongjie Shi, Fang Yu, Mengxin Lu, Zhonghua Yang, Hang Zheng
{"title":"Outcomes of Second Resection Following Conventional Initial Transurethral Resection of Bladder Tumors.","authors":"Song Xu, Hongjie Shi, Fang Yu, Mengxin Lu, Zhonghua Yang, Hang Zheng","doi":"10.1111/iju.70041","DOIUrl":"https://doi.org/10.1111/iju.70041","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the outcomes of the second transurethral resection of bladder tumors.</p><p><strong>Methods: </strong>Patients with bladder cancer who accepted both initial and second resections in our center from January 2021 to March 2024 were included. Tumor residue in the second resection and short-term oncological outcomes were determined. Multivariate analysis was performed to identify predictive factors for them.</p><p><strong>Results: </strong>A total of 125 patients were included. Tumor residue and upstaging were confirmed in 15 (12%) and in 1 (0.8%) patient, respectively. A younger age and a longer time (> 6w) to second resection were associated with a higher tumor residual rate (p < 0.05), and they were confirmed as predictors for tumor residue. Differences were not determined between patients with different tumor characteristics (e.g., Ta vs. T1). A median follow-up of 14 (3-40) months was conducted in 100 patients. Intravesical recurrence and progression were determined in 14 (14%) and 4 (4%) patients, with the 1-year recurrence-free and progression-free survivals of 86.5% and 96.9%, respectively. Maintenance BCG therapy was identified as a predictor for tumor recurrence (HR = 6.168, p < 0.05).</p><p><strong>Conclusions: </strong>A lower tumor residual rate than previously reported was achieved with acceptable short-term oncological outcomes after conventional transurethral resection of bladder tumors. The basis of second resection may need further exploration. Second resection may be prioritized for younger patients and performed within 6 weeks of the initial resection. Maintenance BCG therapy could reduce tumor recurrence after second resection.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585756","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}
Caner Moral, Mustafa Aydın, Ahmet Yılmaz, Lokman İrkılata, Alper Bitkin, Mustafa Koray Kırdağ, Mustafa Kemal Atilla
{"title":"The Relationship Between Restless Legs Syndrome and Overactive Bladder: A Cross-Sectional, Controlled Study.","authors":"Caner Moral, Mustafa Aydın, Ahmet Yılmaz, Lokman İrkılata, Alper Bitkin, Mustafa Koray Kırdağ, Mustafa Kemal Atilla","doi":"10.1111/iju.70036","DOIUrl":"https://doi.org/10.1111/iju.70036","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the common mechanisms in restless legs syndrome (RLS) and overactive bladder (OAB), the prevalence of OAB in RLS, and the effects of RLS treatment on OAB.</p><p><strong>Methods: </strong>Sixty patients newly diagnosed with RLS and 60 healthy individuals in the control group were included in the study. The patients completed the RLS-Severity Rating Scale and were started on pramipexole for treatment. Patients diagnosed with RLS were examined by the same physician for differential diagnosis, and urinalysis, urination diary, and ultrasonography were performed. All patients completed the AAM-V8 form, validated in Turkish, before and after treatment. The treatment effectiveness of the drug on the patients was evaluated using questioning forms.</p><p><strong>Results: </strong>No statistically significant difference was detected between gender and the average age of the patients and the control group (p = 0.540, p = 0.056). In the evaluation, a statistically higher rate of OAB was detected in the RLS group than in the control group (33.3%-13.3%, p < 0.01) and a positive correlation was observed between the severity of RLS symptoms and OAB-V8 scores. After RLS treatment, a statistically significant improvement was observed in the patients' OAB symptom scores compared to before treatment (p < 0.001).</p><p><strong>Conclusions: </strong>Our study revealed that the prevalence of OAB is higher in RLS than in the control group. Dopamine agonists used in the treatment of RLS may be useful as an alternative treatment option in the treatment of OAB, especially in certain patient groups who do not respond to standard treatment.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566628","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":"Real-World Analysis of the Enfortumab Vedotin-Ineligible criTeriA Assessment in Treatment-Naïve Patients With Locally Advanced or Metastatic Urothelial Carcinoma.","authors":"Makito Miyake, Nobutaka Nishimura, Yuki Oda, Takuto Shimizu, Kota Iida, Kiyohide Fujimoto","doi":"10.1111/iju.70040","DOIUrl":"https://doi.org/10.1111/iju.70040","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556886","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}
Alicia K Morgans, Lisa Mucha, Christina Quicquaro, Vanessa Shih, Bin Xie, Christopher Young, Hongbo Yang, Qing Liu, Alexandra Greatsinger, Angela Lax
{"title":"Treatment Patterns, Healthcare Resource Utilization, and Costs Among Patients Diagnosed With Locally Advanced/Metastatic Urothelial Carcinoma Prior to Receiving Enfortumab Vedotin: A Real-World Evidence Study.","authors":"Alicia K Morgans, Lisa Mucha, Christina Quicquaro, Vanessa Shih, Bin Xie, Christopher Young, Hongbo Yang, Qing Liu, Alexandra Greatsinger, Angela Lax","doi":"10.1111/iju.70023","DOIUrl":"https://doi.org/10.1111/iju.70023","url":null,"abstract":"<p><strong>Objective: </strong>To describe real-world patient characteristics, prior treatment patterns, and associated healthcare resource utilization (HRU) and costs among patients with locally advanced/metastatic urothelial carcinoma (la/mUC) treated with enfortumab vedotin (EV).</p><p><strong>Methods: </strong>This retrospective study used the United States (US) Centers for Medicare and Medicaid Services 100% Medicare claims data from 2015 to 2020. Included patients had a diagnosis of la/mUC and received treatment with EV. The index date was the EV initiation date. Endpoints included HRU and costs 12 months before the index date (baseline period) and treatment patterns before EV initiation. Results were summarized descriptively using means and standard deviations for continuous variables, and frequency counts and percentages for categorical variables.</p><p><strong>Results: </strong>Among the 529 included patients, the mean age at the time of EV initiation was 76.5 years. Most patients were White (88.1%) and male (77.1%). Common comorbidities were hypertension (85.1%), renal disease (65.2%), and peripheral vascular disease (42.5%). Platinum-based chemotherapy was the most frequent therapy two lines before EV initiation (43.9%). The most frequent therapy in the line before EV initiation was PD-1/L1 inhibitors (61.4%). The median duration of EV therapy was 4.1 months. The mean all-cause healthcare cost during the baseline period was $106 258 per patient, and 86% had at least one outpatient visit.</p><p><strong>Conclusions: </strong>This real-world study demonstrated that most US patients with la/mUC received platinum-based chemotherapy or a PD-1/L1 inhibitor prior to EV therapy from 2015 to 2020. HRU and costs 12 months before EV initiation suggest a substantial burden in this population. Long-term studies with more recent data are warranted.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556893","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 on Testosterone Recovery and Quality of Life of Japanese Patients After Short-Term Neoadjuvant Androgen Deprivation Therapy With Low-Dose Rate Brachytherapy for Prostate Cancer.","authors":"Takanori Sekito, Takuya Sadahira","doi":"10.1111/iju.70035","DOIUrl":"https://doi.org/10.1111/iju.70035","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556884","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":"Testosterone Recovery and Quality of Life of Japanese Patients After Short-Term Neoadjuvant Androgen Deprivation Therapy With Low-Dose-Rate Brachytherapy for Prostate Cancer.","authors":"Kenta Onishi, Yasushi Nakai, Akira Tachibana, Nobutaka Nishimura, Fumisato Maesaka, Mitsuru Tomizawa, Yosuke Morizawa, Shunta Hori, Daisuke Gotoh, Makito Miyake, Kaori Yamaki, Isao Asakawa, Fumiaki Isohashi, Kiyohide Fujimoto, Nobumichi Tanaka","doi":"10.1111/iju.70018","DOIUrl":"https://doi.org/10.1111/iju.70018","url":null,"abstract":"<p><strong>Objectives: </strong>Androgen deprivation therapy is generally administered alongside radiation therapy for intermediate- or high-risk prostate cancer. However, this treatment results in low testosterone levels, even on a short-term basis. Additionally, after cessation, it may take up to a year for normal testosterone levels to return, which deteriorates quality of life. We investigated the time to testosterone recovery and its association with the hormonal quality of life.</p><p><strong>Methods: </strong>This study included 210 patients at our hospital who received low-dose-rate brachytherapy with short-term (≤ 6 months) neoadjuvant androgen deprivation therapy. Testosterone recovery consisted of three stages: recovery to supracastrate level (serum total testosterone ≥ 0.5 ng/mL), recovery to nonhypogonadism level (serum total testosterone ≥ 1.31 ng/mL), and recovery to normal level (serum total testosterone ≥ 3 ng/mL).</p><p><strong>Results: </strong>The median duration for androgen deprivation therapy was 4 months. The median times to testosterone recovery after cessation were 3.3, 5.7, and 12.2 months for supracastrate, nonhypogonadism, and normal levels, respectively. We used the Expanded Prostate Cancer Index Composite questionnaire to evaluate quality of life. The hormonal domain score deteriorated significantly after the initiation of low-dose-rate brachytherapy until 6 months after treatment and became comparable to the pre-treatment level after 12 months. We determined that the questionnaire subscales for hormonal function and bother domains returned to baseline at 12 and 6 months, respectively.</p><p><strong>Conclusions: </strong>Recovery of total testosterone level after androgen deprivation therapy cessation was a long-term process. The hormonal bother score improved earlier than the hormonal function score on subscales of the hormonal quality of life.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556889","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":"Infectious Complications Following Mini-Endoscopic Combined Intrarenal Surgery at Japanese Tertiary Institutions.","authors":"Takahiko Watanabe, Hiroki Ito, Tetsuo Fukuda, Fukashi Yamamichi, Tadashi Tabei, Takaaki Inoue, Junichi Matsuzaki, Kazuki Kobayashi","doi":"10.1111/iju.70037","DOIUrl":"https://doi.org/10.1111/iju.70037","url":null,"abstract":"<p><strong>Purpose: </strong>To identify risk factors of infectious complications following mini-endoscopic combined intrarenal surgery (ECIRS) in patients with renal or ureteral stones.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients with renal or ureteral stones who underwent mini-ECIRSs at three Japanese tertiary institutions between 2015 and 2021. Data were collected and evaluated regarding patient backgrounds, stone characteristics, and postoperative complications. Among the various complications, multivariable logistic regression analysis was performed using preoperative and intraoperative factors for postoperative fever (≥ 38°C) and septic shock to identify independent risk factors.</p><p><strong>Results: </strong>The data of 1432 cases were collected. Finally, 1035 cases of single-session mini-ECIRS were included in the analysis. In infectious complications, postoperative fever and septic shock were observed in 273 and 21 patients (26.4% and 2.0%). A multivariable logistic regression model identified female (p < 0.001), ureteral stones (p < 0.001), preoperative pyuria (p < 0.001), preoperative urinary tract infection (p = 0.045), preoperative percutaneous nephrostomy (p = 0.001), and operation time (p = 0.017) as predictors of postoperative fever. For septic shock, female (p < 0.001) was shown as a risk factor.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this multicenter cohort study is the largest study investigating infectious complications following mini-ECIRS. Female was a common risk factor for both postoperative fever and septic shock, suggesting that surgeons should pay extra attention to vital signs during the procedure and postoperative infectious complications in mini-ECIRSs for these patients.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541708","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":"Impact of Skin Adverse Events on Prognosis in Patients With Locally Advanced or Metastatic Urothelial Carcinoma Treated With Enfortumab Vedotin: A Real-World Multicenter Study.","authors":"Kai Ozaki, Hayato Yamamoto, Yuya Sekine, Hirotaka Horiguchi, Shogo Hosogoe, Jotaro Mikami, Naoki Fujita, Noriko Tokui, Kazutaka Okita, Teppei Okamoto, Kanami Mori, Mizuki Kobayashi, Kazuyuki Numakura, Takahiro Yoneyama, Ryuji Tabata, Satoshi Sato, Tomonori Habuchi, Chikara Ohyama, Shingo Hatakeyama","doi":"10.1111/iju.70030","DOIUrl":"https://doi.org/10.1111/iju.70030","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the impact of skin adverse events (AEs) of enfortumab vedotin (EV) on prognosis in patients with locally advanced or metastatic urothelial carcinoma in real-world practice.</p><p><strong>Methods: </strong>This study analyzed data from 115 patients with locally advanced or metastatic urothelial carcinoma. We evaluated the association between EV dose and skin AEs in these patients. The impact of skin AEs on progression-free survival (PFS) and overall survival (OS) was assessed using Kaplan-Meier curves and Cox regression analysis.</p><p><strong>Results: </strong>The median PFS and OS were 8.1 and 14.5 months, respectively. EV dose reduction was observed in 68 (59.1%) patients. An estimated dose amount in the first, second, and seventh cycles was 95%, 85%, and 81%, respectively. We observed skin AEs in 69 (60%) cases, and they were observed within 1 month in 53 (76.8%) of cases. Patients with skin AEs had significantly longer PFS and OS compared to those without skin AEs. Multivariable Cox regression analysis showed a significant association of skin AEs with prolonged PFS and OS.</p><p><strong>Conclusions: </strong>Skin AEs were significantly associated with prolonged prognosis compared to those without skin AEs, although EV dose reduction was required in 59.1% of patients. Careful dose adjustment of EV may be crucial for long-term use and optimizing oncological outcomes.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541498","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}