International Journal of Urology最新文献

{"title":"Editorial Comment to \"Double-Sided Heinecke-Mikulicz Urethroplasty for Short Stricture Around Penoscrotal Junction: Description of Technique and Clinical Outcome of Initial Cases\".","authors":"Priyank Yadav","doi":"10.1111/iju.70159","DOIUrl":"https://doi.org/10.1111/iju.70159","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475077","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":"Surgical Outcomes of the Non-renorrhaphy Technique During Robot-Assisted Partial Nephrectomy for Highly Complex Renal Tumors (RENAL Score ≥ 10).","authors":"Kosuke Hamada, Takeshi Yamasaki, Shoma Yamamoto, Taisuke Matsue, Nao Yukimatsu, Taiyo Otoshi, Minoru Kato, Katsuyuki Kuratsukuri, Junji Uchida","doi":"10.1111/iju.70157","DOIUrl":"https://doi.org/10.1111/iju.70157","url":null,"abstract":"<p><strong>Objectives: </strong>Non-renorrhaphy technique during partial nephrectomy has not been sufficiently studied. This study aimed to evaluate the surgical outcomes of the non-renorrhaphy technique in robot-assisted partial nephrectomy (RAPN) for tumors with RENAL scores of 10-12.</p><p><strong>Methods: </strong>We retrospectively analyzed 51 consecutive patients who underwent RAPN with or without renorrhaphy for RENAL score 10-12 tumors at Osaka Metropolitan University Hospital between March 2015 and December 2023. Perioperative outcomes were compared between 16 patients in the nonrenorrhaphy group and 35 patients in the renorrhaphy group. Univariate and multivariate linear regression analyses were conducted to identify predictors of renal function and renal parenchymal volume preservation.</p><p><strong>Results: </strong>Patient demographics and preoperative tumor characteristics exhibited no significant differences between the two groups. Operative time was significantly shorter in the nonrenorrhaphy group (185 vs. 217 min, p = 0.0016). The preservation rate of renal parenchymal volume was significantly higher in the nonrenorrhaphy group (86.7 vs. 74.2%, p = 0.0016), but there was no significant difference in the preservation rate of estimated glomerular filtration rate (p = 0.6380). No significant difference was observed in the incidence of major complications (Clavien-Dindo grade ≥ 3) between the two groups. Urinary leakage occurred in both groups (p = 0.9399). In univariate and multivariate analyses, renorrhaphy and clinical tumor size were identified as significant predictors of renal parenchymal volume preservation.</p><p><strong>Conclusions: </strong>Even in cases with RENAL scores of 10-12, the non-renorrhaphy technique appears to be a feasible and safe approach, and may be associated with better preservation of renal parenchymal volume.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475168","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":"Frontiers of Ultrasound Technology in Prostate Cancer Treatment.","authors":"Sunao Shoji, Kumpei Takahashi, Jun Naruse, Yoshiaki Kawamura","doi":"10.1111/iju.70160","DOIUrl":"10.1111/iju.70160","url":null,"abstract":"<p><p>Focal therapy is a minimally invasive alternative treatment for localized prostate cancer (PC) aiming to achieve oncological control while preserving urinary and sexual functions. High-intensity focused ultrasound (HIFU) and high-intensity directional ultrasound (HIDU) enable precise prostate ablation guided by real-time transrectal ultrasound or magnetic resonance imaging (MRI) fusion imaging. This review evaluates the current status and prospects of ultrasound technology in the treatment of PC. HIFU provides precise tumor ablation with minimal damage to the surrounding tissues, whereas HIDU allows MRI-guided transurethral treatment with real-time thermometry. Clinical studies have reported favorable biochemical recurrence-free survival and functional outcomes. In Japan, a multi-institutional prospective study on focal therapy using HIFU has been approved as an advanced medical technology by the Minister of Health, Labor, and Welfare. This study compared the oncological and functional outcomes of HIFU-based focal therapy and radical prostatectomy in pair-matched patients to evaluate the effectiveness of HIFU in treating localized PC. HIFU induces immunogenic cell death, releases tumor-associated antigens, and reduces immunosuppressive cells. Low-intensity focused ultrasound enhances tumor immunogenicity by promoting heat shock protein expression and CD8⁺ T cell activation. In conclusion, HIFU and HIDU offer effective focal therapy options for localized PC, and the immunomodulatory properties of HIFU and low-intensity focused ultrasound may benefit advanced PC treatment. Future studies should optimize patient selection by developing advanced imaging technologies and predictive models capable of visualizing MRI-invisible lesions and accurately detecting micro-metastatic disease. Moreover, evaluating long-term outcomes and exploring their combination with immunotherapy to enhance oncological efficacy will be essential.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368822","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":"Evaluation of Complication, Renal Function, and Recurrence-Free Survival in Hilar and Non-Hilar Tumors During Robot-Assisted Partial Nephrectomy: A Propensity Score-Matched Analysis.","authors":"Kentaro Muraoka, Daiki Takeya, Kazuhiro Nishimura, Seiichiro Honda, Yasuhiro Numata, Kota Kobayashi, Ryosuke Jikuya, Tomoyuki Tatenuma, Go Noguchi, Daiki Ueno, Mitsuru Komeya, Hiroki Ito, Yusuke Ito, Hisashi Hasumi, Kazuhide Makiyama","doi":"10.1111/iju.70156","DOIUrl":"10.1111/iju.70156","url":null,"abstract":"<p><strong>Objective: </strong>To compare complications, perioperative outcomes, postoperative renal function, and recurrence-free survival (RFS) between robot-assisted partial nephrectomy (RAPN) for hilar and non-hilar tumors.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of patients who underwent RAPN between March 2016 and August 2023. Patient demographic characteristics were adjusted using 1:1 propensity score matching.</p><p><strong>Results: </strong>A total of 618 patients (524 with non-hilar tumors and 94 with hilar tumors) were analyzed. Hilar tumors exhibited a larger tumor size, higher RENAL nephrometry score (RNS), and greater complexity than non-hilar tumors pre-matching (all p < 0.05). Propensity score matching resulted in 77 patients per group, with no significant baseline differences except for the L factor of the RNS. Before propensity score matching, hilar tumors were associated with a higher frequency of renal artery/vein clamping and intraperitoneal approaches, as well as significantly longer operative and warm ischemia times than non-hilar tumors. However, after matching, these differences were no longer significant. The adverse event rate was not significantly different between the hilar and non-hilar tumor groups. Trifecta achievement rates were significantly lower in hilar tumors before matching (p < 0.001) but were comparable after matching (p = 0.325). No significant differences were observed in the postoperative eGFR, preservation at 1, 3, and 12 months, or pentafecta rates. Before matching, RFS was significantly lower in hilar tumors (p = 0.015); however, this difference was not significant after matching (p = 0.186).</p><p><strong>Conclusion: </strong>Hilar tumors showed similar complications, renal function, and recurrence-free survival rates as non-hilar tumors, indicating that RAPN is safe and feasible for hilar tumors.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333113","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":"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":"<p><strong>Objectives: </strong>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).</p><p><strong>Material and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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}

{"title":"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\".","authors":"Ryuta Watanabe","doi":"10.1111/iju.70150","DOIUrl":"https://doi.org/10.1111/iju.70150","url":null,"abstract":"","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":"144309868","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":"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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","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}

{"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":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","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}

{"title":"Ceratonia siliqua Protects Testicular Tissue in Ischemia/Reperfusion Injury: Limitations and Future Directions","authors":"Yitong Weng,&nbsp;Bing Ji","doi":"10.1111/iju.70155","DOIUrl":"10.1111/iju.70155","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"908-909"},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309867","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":"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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}