International Journal of Urology最新文献

{"title":"Younger Age Is Associated With Slower PSA Decline After Low-Dose-Rate Brachytherapy for Localized Prostate Cancer","authors":"Yasushi Nakai,&nbsp;Kenta Onishi,&nbsp;Makito Miyake,&nbsp;Kaori Yamaki,&nbsp;Fumiaki Isohashi,&nbsp;Isao Asakawa,&nbsp;Nobumichi Tanaka","doi":"10.1111/iju.70653","DOIUrl":"10.1111/iju.70653","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the association of age with PSA kinetics and biochemical control after low-dose-rate brachytherapy (LDR-BT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 347 patients treated with LDR-BT alone without androgen deprivation therapy between 2004 and 2015. Longitudinal PSA changes were evaluated using linear mixed-effects models with natural cubic splines for time. Age was modeled as a continuous fixed effect, including interactions with the spline terms for time. Time to PSA nadir &lt; 0.2 ng/mL was evaluated using Cox proportional hazards models, whereas biochemical recurrence was evaluated using Fine–Gray competing-risk regression with death treated as a competing event.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Younger age was significantly associated with slower PSA decline over 5 years (<i>p</i> &lt; 0.001). Each 1-year increase in age was associated with model-estimated PSA levels relative to baseline that were 4.6%, 6.4%, and 4.3% lower at 1, 3, and 5 years, respectively. This association remained significant after adjustment for Gleason grade group and treatment era and after excluding patients with PSA bounce (both <i>p</i> &lt; 0.001). Median time to PSA nadir &lt; 0.2 ng/mL was 54 months in patients aged &lt; 65 years and 36 months in those aged ≥ 75 years. Increasing age was associated with earlier achievement of PSA nadir &lt; 0.2 ng/mL (HR 1.04 per year, 95% CI 1.02–1.06) but was not significantly associated with biochemical recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Age was significantly associated with PSA kinetics following LDR-BT, with younger patients showing slower PSA decline and a delayed achievement of PSA nadir &lt; 0.2 ng/mL. However, these age-related differences were not associated with biochemical recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127501","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":"Severe Interstitial Lung Disease With First-Line Enfortumab Vedotin Plus Pembrolizumab in Japanese Real-World Practice","authors":"Ryo Kasahara","doi":"10.1111/iju.70660","DOIUrl":"10.1111/iju.70660","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127516","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":"Oncological Outcomes of Neoadjuvant Chemotherapy in High-Risk UTUC: A Multicenter Study","authors":"Shinpei Saito,&nbsp;Tomokazu Sazuka,&nbsp;Satoshi Washino,&nbsp;Go Kaneko,&nbsp;Shoichi Nagamoto,&nbsp;Yuki Nakamura,&nbsp;Akinori Nakayama,&nbsp;Sangjon Pae,&nbsp;Keisuke Ando,&nbsp;Yasutaka Yamada,&nbsp;Yusuke Imamura,&nbsp;Shinichi Sakamoto","doi":"10.1111/iju.70662","DOIUrl":"10.1111/iju.70662","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the effect of neoadjuvant chemotherapy (NAC) on pathological response and oncologic outcomes in patients with high-risk upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU) in a real-world multicenter setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from 184 patients with high-risk UTUC who underwent RNU across six institutions and were divided into NAC and non-NAC groups. The primary endpoint was pathological downstaging. Secondary endpoints were non-urinary-tract recurrence-free survival (NUT-RFS) and overall survival (OS). We also compared the NAC group with the combined non-NAC and adjuvant chemotherapy (AC) group. Propensity score matching (PSM) was performed to adjust for baseline differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>34.2% and 14.1% of 184 patients (median age, 75 years; men, 70.7%) received NAC and AC, respectively. NAC was not significantly associated with pathological downstaging. On multivariable analysis, positive urine cytology (bladder) was independently associated with a lower likelihood of downstaging, whereas a higher baseline eGFR was independently associated with a higher likelihood of downstaging. Neither NUT-RFS nor OS differed significantly between the NAC and non-NAC groups or between the NAC and non-NAC plus AC groups, either in the overall cohort or after PSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this real-world cohort, NAC did not significantly improve pathological or survival outcomes in patients with high-risk UTUC. Oncological outcomes did not differ significantly between NAC and AC administered after pathological confirmation of risk, although this comparison is susceptible to selection and guarantee-time bias. Pathology-guided AC may be a reasonable perioperative strategy, but its relative benefit remains uncertain and warrants prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127391","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":"Oncological Outcomes and Safety Profiles of Adjuvant Nivolumab in Muscle-Invasive Urothelial Carcinoma.","authors":"Satoshi Katayama, Tatsushi Kawada, Keiichiro Mori, Kosuke Iwatani, Shota Inoue, Tomofumi Watanabe, Ichiro Tsuboi, Tomoaki Yamanoi, Takehiro Iwata, Kazuma Tsuboi, Wataru Murao, Tetsuya Nakada, Kohei Ogawa, Akihiro Matsukawa, Takafumi Yanagisawa, Shingo Nishimura, Kensuke Bekku, Koichiro Wada, Takahiro Kimura, Motoo Araki","doi":"10.1111/iju.70664","DOIUrl":"10.1111/iju.70664","url":null,"abstract":"<p><strong>Objectives: </strong>Perioperative immunotherapy has become the standard of care in patients with high-risk muscle-invasive urothelial carcinoma (MIUC). This study aimed to clarify oncological outcomes and safety profiles of adjuvant nivolumab therapy in MIUC, focusing on upper tract urothelial carcinoma (UTUC).</p><p><strong>Methods: </strong>This multicenter study comprised 97 patients undergoing removal of primary tumors, followed by adjuvant nivolumab therapy with a potential follow-up period ≥ 12 months. Patients were divided according to the primary tumor location: bladder cancer (BC), n = 66 (68%); UTUC, n = 31 (32%). Multivariable Cox regression analyses were applied to identify prognostic factors for disease-free survival (DFS).</p><p><strong>Results: </strong>Before surgery, 38% of patients had an estimated glomerular filtration rate (eGFR) < 50 mL/min/1.73m², but this proportion increased to 57% at nivolumab initiation with 19% of UTUC having eGFR < 30. The overall DFS at 6 months was 61.5%. DFS did not differ significantly between BC and UTUC (p = 0.83). On multivariable analyses, a higher absolute eosinophil count was significantly associated with worse DFS (HR 2.24; 95% CI, 1.24-4.03, p = 0.007), while primary tumor location was not. Immune-related adverse events (irAEs) of adrenal insufficiency and hypophysitis occurred in 8% and 4% of patients, respectively, with grade ≥ 3 occurring at 3.3-18.3 months.</p><p><strong>Conclusions: </strong>Adjuvant nivolumab therapy may provide comparable oncological outcomes between BC and UTUC. Baseline eosinophil count was an independent prognosticator for DFS. The incidences of adrenal insufficiency and hypophysitis appeared higher in our real-world data. Clinicians should recognize these irAEs due to nonspecific symptoms and considerable variability in time of onset.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":"e70664"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224089","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":"Editorial Comment on Prognostic Stratification in High-Volume Metastatic Hormone-Sensitive Prostate Cancer Treated With First-Line Androgen Receptor Pathway Inhibitor-Based Combination Therapy.","authors":"Kensuke Mitsunari, Yuichiro Nakamura, Ryoichi Imamura","doi":"10.1111/iju.70674","DOIUrl":"https://doi.org/10.1111/iju.70674","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":"e70674"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224077","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 Depressive Symptom Severity Is Associated With IPSS and ICIQ-SF Scores but Not Overactive Bladder in Japanese Male Never-Smokers.","authors":"Ryuji Sakakibara","doi":"10.1111/iju.70676","DOIUrl":"10.1111/iju.70676","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":"e70676"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206891","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 Visceral Fat Volume and Inguinal Hernia After Robot-Assisted Radical Prostatectomy: A Three-Dimensional CT Analysis.","authors":"Masaki Shimbo","doi":"10.1111/iju.70673","DOIUrl":"https://doi.org/10.1111/iju.70673","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":"e70673"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224079","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":"Overactive Bladder Pharmacotherapy and Long-Term Care Needs, Dementia, and Frailty in Older Women","authors":"Kana Ito,&nbsp;Yoko Sato,&nbsp;Nagato Kuriyama,&nbsp;Yoshihiro Tanaka","doi":"10.1111/iju.70652","DOIUrl":"10.1111/iju.70652","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the associations of anticholinergic agents and β3-adrenergic receptor agonists (β3-agonists) prescribed for overactive bladder (OAB) with worsening long-term care needs, incident dementia, and frailty among older women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/Patients and Methods</h3>\u0000 \u0000 <p>This retrospective cohort study used the Shizuoka Kokuho Database, a population-based administrative claims database in Japan. Women aged 65–84 years who newly initiated anticholinergic agents or β3-agonists for OAB between 2012 and 2024 and had prescription records consistent with continuous treatment for at least 1 year were included. Follow-up began 12 months after treatment initiation. Stabilized inverse probability of treatment weighting (sIPTW) was used to balance baseline covariates between groups. Primary outcomes were worsening long-term care needs and incident dementia; the secondary outcome was changes in the electronic Frailty Index (eFI). Time-to-event outcomes were analyzed using sIPTW-weighted Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort comprised 1 605 anticholinergic and 2 189 β3-agonist users. After sIPTW, baseline covariates were well-balanced. No significant difference was observed in worsening long-term care needs (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.87–1.22). Anticholinergic use was associated with a higher risk of claims-defined incident dementia compared with β3-agonist use (HR, 1.49; 95% CI, 1.04–2.13). Median eFI did not differ significantly between the groups during 5 years of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among older women with OAB, anticholinergic use was associated with an increased risk of claims-defined incident dementia but not with worsening long-term care needs or frailty compared with β3-agonists. Residual confounding and differential dementia ascertainment cannot be excluded.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080862","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":"Depressive Symptom Severity Is Associated With IPSS and ICIQ-SF Scores but Not Overactive Bladder in Japanese Male Never-Smokers","authors":"Masanobu Yamazaki,&nbsp;Sahoko Ninomiya,&nbsp;Akihito Hashizume,&nbsp;Teppei Takeshima,&nbsp;Hiroki Ito,&nbsp;Kazuhide Makiyama,&nbsp;Hiroji Uemura,&nbsp;Jun-Ichi Teranishi,&nbsp;Takashi Kawahara","doi":"10.1111/iju.70655","DOIUrl":"10.1111/iju.70655","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Lower urinary tract symptoms (LUTS) are common in men and have been linked to mental health, but their relationship with depressive symptoms across the adult age range, including young men, remains unclear. We examined the association between LUTS and depressive symptoms in Japanese men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using an internet research panel, 4000 never-smoking Japanese men were surveyed. LUTS were assessed with the Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), International Prostate Symptom Score (IPSS), and Quality of Life (QOL) index, and depressive symptoms with the Quick Inventory of Depressive Symptomatology, Japanese version (QIDS-J). Scores were compared across QIDS-J severity groups, and multivariable regression was used to adjust for age and household income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2568 respondents (mean age 46.6 years), more severe depressive symptoms were associated with younger age (<i>p</i> &lt; 0.001). ICIQ-SF and IPSS increased with QIDS-J severity (both <i>p</i> &lt; 0.001) and remained independently associated after adjustment for age and income (IPSS adjusted <i>β</i> 0.32; ICIQ-SF 0.13; both <i>p</i> &lt; 0.001), whereas OABSS was not associated (<i>p</i> = 0.193). The same pattern was observed in men aged 20–40 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Greater depressive symptom severity was independently associated with higher IPSS and ICIQ-SF scores, but not with OABSS, OAB, or UUI among Japanese male never-smokers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080872","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":"Editorial Comment to Cancer-Control Outcomes of Japanese Versus German Metastatic Hormone-Sensitive Prostate Cancer Patients: A Real-World Cross-Country Comparison of Patients Undergoing Combination Therapies","authors":"Satoshi Fukata","doi":"10.1111/iju.70659","DOIUrl":"https://doi.org/10.1111/iju.70659","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068322","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}