International Journal of Urology最新文献

{"title":"Editorial Comment to Impact of Clinicopathological and Institutional Factors on the Clinical Courses of Patients With Localized Prostate Cancer Initially Managed by Active Surveillance: An Analysis of Nationwide Real-World Data From Japan.","authors":"Yoichiro Tohi, Mikio Sugimoto","doi":"10.1111/iju.70685","DOIUrl":"https://doi.org/10.1111/iju.70685","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244367","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 and Validation of the JIKEI-YAYOI Score for Predicting Castration Resistance in Metastatic Castration-Sensitive Prostate Cancer Treated With ARSI-Based Doublet Therapy.","authors":"Fumihiko Urabe, Yudai Ishiyama, Wataru Fukuokaya, Naoki Fujita, Hiromi Sato, Takuma Narita, Masataka Kubo, Takafumi Yanagisawa, Kojiro Tashiro, Shintaro Narita, Tomonori Habuchi, Shingo Hatakeyama, Takahiro Kimura","doi":"10.1111/iju.70677","DOIUrl":"https://doi.org/10.1111/iju.70677","url":null,"abstract":"<p><strong>Background: </strong>Metastatic castration-sensitive prostate cancer (mCSPC) is a heterogeneous disease with variable clinical outcomes despite advances in androgen receptor signaling inhibitor (ARSI)-based therapy. We aimed to develop and externally validate a prognostic model for predicting progression to castration-resistant prostate cancer (CRPC) in patients with mCSPC.</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with mCSPC treated with ARSI doublet therapy. The development cohort comprised 388 patients, whereas the external validation cohort included 451 patients. Prognostic factors for CRPC-free survival (CRPC-FS) were identified using Cox proportional hazards regression models. A point-based risk score (JIKEI-YAYOI score) was derived from regression coefficients. Model performance was evaluated through assessment of discrimination, calibration, and external validation.</p><p><strong>Results: </strong>In the development cohort, the median CRPC-FS was 21 months. Grade Group, extent of disease score, hemoglobin, and lactate dehydrogenase were independently associated with CRPC progression and were incorporated into the model. The model demonstrated good discrimination (apparent C-index, 0.715; optimism-corrected C-index, 0.720). The JIKEI-YAYOI score ranged from 0 to 8, corresponding to a 3-year CRPC risk of 10.6%-93.2%. Patients were stratified into low-risk (≤ 2), intermediate-risk (3-4), and high-risk (≥ 5) groups, with significantly different CRPC-FS and overall survival (both p < 0.001). External validation confirmed good discrimination, calibration, and risk stratification.</p><p><strong>Conclusions: </strong>The JIKEI-YAYOI score is a simple, clinically applicable tool for predicting progression to CRPC in patients with mCSPC. Using routinely available clinical variables, it enables individualized risk assessment and may support clinical decision-making regarding surveillance and treatment strategies.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238387","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":"Intraoperative Ultrasound Guided Sling Adjustment During Transobturator Sling Placement: A Preliminary Pilot Report of the Technical Protocol and Feasibility.","authors":"Wen-Chen Huang, Jenn-Ming Yang","doi":"10.1111/iju.70672","DOIUrl":"https://doi.org/10.1111/iju.70672","url":null,"abstract":"<p><strong>Objectives: </strong>To describe a qualitative intraoperative ultrasound protocol for transobturator mid-urethral sling adjustment and assess technical feasibility.</p><p><strong>Methods: </strong>This retrospective pilot series included 58 consecutive women with urodynamically confirmed stress urinary incontinence or stress-predominant mixed urinary incontinence undergoing outside-in transobturator sling placement. Sagittal and axial images guided gentle traction for a visible tape-urethra gap and tension release for urethral encroachment. Sling-arm oscillation supplemented assessment when acoustic shadowing limited visualization. Feasibility measures included visualization, adjustment frequency, final sonographic findings, scanning duration, and intraoperative complications. Clinical outcomes were summarized using available cases.</p><p><strong>Results: </strong>The tape was visualized in all 58 procedures and adjusted in 26 (44.8%). No final residual gap or encroachment was observed. Median scanning duration was 3 min 45 s (interquartile range, 3-4 min); no intraoperative complications were recorded. All 58 women provided baseline and 3-month questionnaire data. Mean six-item Urogenital Distress Inventory scores decreased from 68.3 ± 17.2 to 20.0 ± 6.7; seven-item Incontinence Impact Questionnaire scores decreased from 75.4 ± 10.5 to 18.2 ± 6.7. At 36 months, 20/58 women (34.5%) had outcome data. All 20 met the objective stress continence criterion (exact two-sided 95% confidence interval, 83.2%-100%); none met the objective voiding dysfunction criterion (exact two-sided 95% confidence interval, 0%-16.8%). These findings concern only the retained subgroup.</p><p><strong>Conclusions: </strong>The protocol was technically feasible in this single-surgeon, single-center series. Reproducibility, workflow burden, and clinical benefit require prospective evaluation.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238364","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":"What Does Sitafloxacin Teach Us About Fluoroquinolone Resistance in Mycoplasma genitalium?","authors":"Takashi Deguchi","doi":"10.1111/iju.70687","DOIUrl":"https://doi.org/10.1111/iju.70687","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244415","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 Characteristics and Early Outcomes of Enfortumab Vedotin Plus Pembrolizumab in Advanced Urothelial Carcinoma.","authors":"Takuya Tsujino, Keita Tamura, Rikiya Taoka, Makito Miyake, Keita Kobayashi, Yutaro Sasaki, Kohei Ogawa, Shuichi Tatarano, Satoshi Katayama, Minoru Kato, Yohei Abe, Yuki Oda, Koichiro Wada, Junya Furukawa, Motoo Araki, Hideki Enokida, Koji Shiraishi, Keiji Inoue, Teruo Inamoto, Haruhito Azuma","doi":"10.1111/iju.70682","DOIUrl":"https://doi.org/10.1111/iju.70682","url":null,"abstract":"<p><strong>Background: </strong>Enfortumab vedotin (EV) plus pembrolizumab (EVP) has become a standard first-line regimen for unresectable locally advanced or metastatic urothelial carcinoma. Further characterization of clinical heterogeneity and toxicity may complement existing Japanese real-world data.</p><p><strong>Methods: </strong>We conducted a multicenter prospective study across 11 Japanese institutions. Consecutive patients who initiated EVP for unresectable locally advanced or metastatic urothelial carcinoma between October 2024 and December 2025 were included. Patient characteristics, treatment exposure, response, adverse events, and short-term survival outcomes were descriptively analyzed.</p><p><strong>Results: </strong>A total of 172 patients were included. Median age was 75 years, 73.8% had creatinine clearance < 60 mL/min, and 76.7% were classified as cisplatin-unfit using modified Galsky criteria. Upper tract urothelial carcinoma accounted for 35.5% of cases. Median follow-up was 7.1 months. Early EV dose reduction was recorded in 44.8% of patients, and discontinuation of at least one agent occurred in 61.0%. Among 158 response-evaluable patients, the best overall objective response rate was 62.7% and the disease control rate was 82.3%; corresponding all-treated estimates were 57.6% and 75.6%, respectively. Skin reaction was the most common adverse event, while pneumonitis was a major cause of treatment discontinuation.</p><p><strong>Conclusions: </strong>In Japanese real-world practice, EVP was frequently used in older, renally impaired, cisplatin-unfit patients. Response was clinically meaningful among evaluable patients, but interpretation requires caution because of short follow-up and denominator-dependent response estimates.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267483","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 \"Distinct Predictors of Early Postoperative and Long-Term Renal Function Decline Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma\".","authors":"Naoki Fujita","doi":"10.1111/iju.70680","DOIUrl":"https://doi.org/10.1111/iju.70680","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238333","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":"Maternal Parenting Styles and Nighttime Diaper Use in Early Childhood: The Japan Environment and Children's Study.","authors":"Akihisa Hasegawa, Kenji Omae, Yusuke Kirihana, Kei Yaginuma, Satoru Meguro, Kanako Matsuoka, Junya Hata, Yuichi Sato, Soichiro Ogawa, Yuka Ogata, Akiko Sato, Takahiro Nozaki, Takahiro Omoto, Hidekazu Kuraya, Hidekazu Nishigori, Hayato Go, Seiji Yasumura, Keiya Fujimori, Mitsuaki Hosoya, Koichi Hashimoto, Noriaki Kurita, Yoshiyuki Kojima","doi":"10.1111/iju.70661","DOIUrl":"https://doi.org/10.1111/iju.70661","url":null,"abstract":"<p><strong>Purpose: </strong>To examine cross-sectional and longitudinal associations between maternal parenting style and nighttime diaper use in early childhood.</p><p><strong>Methods: </strong>We analyzed data from the Japan Environment and Children's Study, a nationwide prospective birth cohort. Maternal parenting styles were categorized as Authoritative, Authoritarian, Permissive, or Uninvolved using responsiveness and demandingness scores from a validated parenting attitude questionnaire. Nighttime diaper use was assessed at ages 3 and 4 years. Multivariable modified Poisson regression with robust error variance was applied to estimate adjusted prevalence ratios (aPRs) for nighttime diaper use at age 3 and adjusted risk ratios (aRRs) for its persistence from ages 3 to 4.</p><p><strong>Results: </strong>The cross-sectional and longitudinal analyses included 65 765 and 54 915 mother-child pairs, respectively. Compared with the Uninvolved style, aPRs for nighttime diaper use at age 3 were 0.96 (95% CI, 0.95-0.97) for Authoritative, 0.99 (95% CI, 0.98-1.00) for Authoritarian, and 0.99 (95% CI, 0.99-1.00) for Permissive styles. The corresponding aRRs for persistent nighttime diaper use were 0.93 (95% CI, 0.91-0.95), 0.96 (95% CI, 0.94-0.98), and 0.98 (95% CI, 0.96-1.01). No significant interaction was found with child sex, whereas a significant interaction was observed between child developmental status and Authoritarian style.</p><p><strong>Conclusions: </strong>Maternal parenting styles were associated with nighttime diaper use at age 3 and its persistence at age 4. Although nighttime diaper use is not a direct measure of nocturnal continence, these findings suggest that maternal caregiving context may be relevant to early nighttime diaper discontinuation before school age.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: UMIN000030786.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267474","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":"Changes in Treatment Patterns and Survival Outcomes Across Therapeutic Eras in Metastatic Urothelial Carcinoma: A Multicenter Real-World Study.","authors":"Sadafumi Tomioka, Satoshi Inoue, Rion Kawase, Yuriko Nagasaka, Tomoki Hattori, Noritoshi Shamoto, Fumihiro Ito, Yuri Yuguchi, Hideji Kawanishi, Motohiro Maeda, Kosuke Tochigi, Shusuke Akamatsu, Kenji Zennami","doi":"10.1111/iju.70679","DOIUrl":"10.1111/iju.70679","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate temporal changes in treatment patterns and survival outcomes across therapeutic eras in patients with metastatic urothelial carcinoma.</p><p><strong>Methods: </strong>This retrospective multicenter real-world cohort study included 727 patients with metastatic urothelial carcinoma who received first-line systemic therapy between July 2003 and September 2024. Patients were categorized into three treatment eras according to the initiation date of first-line systemic therapy: the chemotherapy era (Chemo era), pembrolizumab era (Pembro era), and avelumab era (Ave era). Overall survival was analyzed using the Kaplan-Meier method and compared using the log-rank test. Cox proportional hazards regression analyses identified independent prognostic factors.</p><p><strong>Results: </strong>Median overall survival was 12.7, 19.7, and 21.8 months in the Chemo, Pembro, and Ave eras, respectively. Overall survival was significantly shorter in the Chemo era than in the other eras, whereas no significant difference was observed between the Pembro and Ave eras. In multivariable analysis, poor performance status, hypoalbuminemia, elevated neutrophil-to-lymphocyte ratio, elevated C-reactive protein level, and liver, lung, and bone metastasis were independently associated with poorer overall survival. The Pembro and Ave eras were independently associated with prolonged overall survival compared with the Chemo era. Treatment patterns changed over time, with decreasing use of chemotherapy alone and increasing use of pembrolizumab-, avelumab-, and enfortumab vedotin-containing treatment sequences.</p><p><strong>Conclusions: </strong>In this real-world cohort, survival outcomes improved across successive therapeutic eras in patients with metastatic urothelial carcinoma. Treatment patterns evolved with the introduction of novel systemic therapies, providing contemporary real-world evidence of changing treatment practices and outcomes.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238410","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}