International Journal of Urology最新文献

{"title":"Evaluating the Safety of Delaying Surgery Beyond 9 Months in Localized Prostate Cancer Patients: Results From a Prospective Study With Propensity Score Matching.","authors":"Maxime Pattou, Yann Neuzillet, Tarek Ghoneim, Pierre-Olivier Bosset, Victor Vanalderverelt, Denis Bohin, Pierre-Marie Lugagne, Yanish Soorojebally, Marc Schneider, Xavier Cathelineau, Morgan Rouprêt, Sarah J Drouin, Thierry Lebret","doi":"10.1111/iju.70142","DOIUrl":"https://doi.org/10.1111/iju.70142","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal timing of radical prostatectomy (RP) after prostate cancer diagnosis is controversial, particularly concerning the impact of surgical delays on oncological outcomes. While active surveillance is standard for low-risk prostate cancer, the effects of delaying surgery in intermediate- and high-risk patients are less clear. We aimed to evaluate the impact of surgical delays exceeding 9 months on pathological outcomes: upstaging (pT ≥ 3a), upgrading (ISUP ≥ 4) and biochemical recurrence (BCR) in patients undergoing RP with a localized disease.</p><p><strong>Methods: </strong>A prospective cohort study was conducted across four French academic hospitals between June 2013 and June 2021, including consecutive patients scheduled for RP according to established clinical guidelines. A 9-month surgical delay threshold between prostate biopsies and surgery was chosen. The primary endpoint was BCR rates while secondary endpoints included International Society of Urological Pathology (≥ ISUP 4) upgrading and ≥ pT3a upstaging. A propensity score was used to homogenize PSA levels, biopsy ISUP, and D'Amico risk categories between both populations.</p><p><strong>Results: </strong>After propensity score matching, 881 patients were analyzed, with a median surgical delay of 3.5 months IQR (2.6-4.6). After a median follow-up of 48.0 months IQR (25.0-60.0), BCR occurred in 156 patients (17.7%). Delaying surgery of more than 9 months was not significantly associated with worse BCR-free survival in patients with PSA < 20 ng/mL and ISUP grade < 4 (D'Amico low to intermediate high). Upgrading (ISUP ≥ 4) and/or upstaging (≥ pT3a) occurred in 35% of patients, but was not impacted by a surgical delay of more than 9 months in the multivariate model.</p><p><strong>Conclusion: </strong>Delaying surgery over 9 months does not seem to adversely impact pathological outcomes and BCR rates in nonhigh-risk patients undergoing RP for localized prostate cancer.</p><p><strong>Trial registration: </strong>NCT02235142.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215788","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 Outcomes of First-Line Systematic Treatment in Locally Advanced or Metastatic Upper Urinary Tract Urothelial Carcinoma With Renal Impairment (YUSHIMA Study).","authors":"Tomoki Kimura, Motohiro Fujiwara, Yuya Maezawa, Kensaku Ishihara, Naoki Inoue, Kenji Tanabe, Keita Izumi, Masahiro Toide, Takanobu Yamamoto, Sho Uehara, Saori Araki, Masaharu Inoue, Ryoji Takazawa, Noboru Numao, Yukihiro Ohtsuka, Yuma Waseda, Hajime Tanaka, Soichiro Yoshida, Yasuhisa Fujii","doi":"10.1111/iju.70136","DOIUrl":"https://doi.org/10.1111/iju.70136","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the impact of renal impairment (RI) on the efficacy of first-line chemotherapy in patients with locally advanced or metastatic upper tract urothelial carcinoma (la/mUTUC).</p><p><strong>Methods: </strong>This multicenter retrospective study evaluated 300 patients with la/mUTUC who received GEM/CDDP or GEM/CBDCA as first-line chemotherapy. RI was defined as eGFR < 45 mL/min/1.73 m² and used to categorize patients into RI and without-RI groups. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were analyzed. Multivariable Cox proportional hazard analysis was conducted to assess risk factors for PFS and OS. In the RI group, oncologic outcomes were compared between GEM/CDDP and GEM/CBDCA.</p><p><strong>Results: </strong>Overall, 130 patients (43%) had RI, and 170 (57%) did not. During a median follow-up of 32 months, 188 patients (63%) died: 74 patients (56%) in the RI group and 114 (67%) in the without-RI group. Among 288 evaluable patients, the ORR was 34% in the RI group and 45% in the without-RI group (p = 0.072). The median PFS of the RI and without-RI groups was 5.6 and 4.8 months, respectively (p = 0.322), and the median OS was 16.9 and 14.5 months, respectively (p = 0.074). Among the RI group, no significant differences were observed between GEM/CDDP and GEM/CBDCA in PFS (6.4 vs. 4.2 months, p = 0.113) or OS (21.4 vs. 15.2 months, p = 0.142).</p><p><strong>Conclusions: </strong>In la/mUTUC, oncologic outcomes were comparable between patients with and without RI. In the RI group, responses to GEM/CDDP and GEM/CBDCA did not differ.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215789","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 Ziylan O, et al. Two-Stage Repair for Re-Do Hypospadias: Results of Over 5-Year Follow-Up.","authors":"V V S Chandrasekharam","doi":"10.1111/iju.70147","DOIUrl":"https://doi.org/10.1111/iju.70147","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215787","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":"VIRMA Accelerates the Tumorigenesis of Prostate Cancer via Regulating the m⁶A Modification of NSMCE2 to Eliminate the Generation of Reactive Oxygen Species.","authors":"Jinhua Ma, Xi Qu","doi":"10.1111/iju.70140","DOIUrl":"https://doi.org/10.1111/iju.70140","url":null,"abstract":"<p><strong>Objectives: </strong>N6-methyladenosine (m⁶A) modification is a key mechanism to regulate the tumorigenesis of prostate cancer (PC). However, the function of Vir Like M6A Methyltransferase Associated (VIRMA), an m⁶A writer, in PC remains further explored. Therefore, the objective of this study is to verify the function and mechanism of VIRMA in PC via non-SMC Element 2 (NSMCE2) and reactive oxygen species (ROS).</p><p><strong>Methods: </strong>The effects of VIRMA and NSMCE2 on PC cell malignancy were detected via a series of cell experiments. qRT-PCR, MeRIP, mRNA stability, and RIP assays were performed to further verify the regulatory mechanism of VIRMA on NSMCE2. ROS levels, oxidative stress markers, and cell apoptosis were detected by DCFH-DA, commercial kits, and flow cytometry methods. In vivo assays were performed to confirm the effects of the VIRMA/NSMCE2 axis on tumor growth.</p><p><strong>Results: </strong>VIRMA and NSMCE2 were both upregulated in PC samples, and VIRMA expression was positively correlated to NSMCE2 expression in PC samples. After silencing VIRMA in PC cells, the abilities of proliferation, migration, and invasion were impaired. However, the anti-tumor effects of VIRMA knockdown on PC cell malignancy in vitro and tumor growth in vivo could be reversed by NSMCE2 overexpression. In addition, VIRMA mediated m⁶A modification of NSMCE2 to enhance the mRNA stability of NSMCE2 via an IGF2BP1-dependent manner, thereby reducing ROS levels and the apoptosis rate.</p><p><strong>Conclusion: </strong>VIRMA accelerates PC tumorigenesis by inducing the m⁶A modification of NSMCE2 to eliminate the generation of ROS.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208460","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 Survivorship Postretroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer: A Systematic Review.","authors":"Benjamin M Mac Curtain","doi":"10.1111/iju.70141","DOIUrl":"https://doi.org/10.1111/iju.70141","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215786","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":"Is Testosterone Replacement Therapy Effective and Safe Even for Eugonadal Men With Symptoms of Late-Onset Hypogonadism?","authors":"Keisuke Ishikawa, Akira Tsujimura, Takashi Kanda, Syuichiro Narita, Yuta Anno, Haruhiko Wakita, Ayumu Taniguchi, Yuka Uesaka, Taiji Nozaki, Masato Shirai, Kazuhiro Kobayashi, Shigeo Horie","doi":"10.1111/iju.70128","DOIUrl":"https://doi.org/10.1111/iju.70128","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the efficacy and safety of testosterone replacement treatment for eugonadal patients with symptoms of late-onset hypogonadism.</p><p><strong>Materials and methods: </strong>565 eugonadal men with symptoms of late-onset hypogonadism who underwent testosterone replacement treatment were included in this study. Physical factors, laboratory and endocrinologic variables, and scores of several questionnaires were evaluated. Testosterone replacement treatment was administered with intramuscular injection of 250 mg of testosterone esters, and efficacy was assessed by patient satisfaction. First, we evaluated the efficacy rate and safety of testosterone replacement treatment and then investigated the independent factors influencing its efficacy.</p><p><strong>Results: </strong>Testosterone replacement treatment was effective in 131 of 216 patients (60.6%), 111 of 163 patients (68.1%), and 126 of 186 patients (67.7%) with mental, physical, and sexual dysfunction, respectively. The overall efficacy rate was 65.1%. No side effects were observed after testosterone replacement treatment. Only the total score of the Aging Male Symptoms rating scale was identified as a factor predictive of patient satisfaction.</p><p><strong>Conclusions: </strong>This study is the first, to our knowledge, to report the efficacy and safety of testosterone replacement treatment for eugonadal men with symptoms of late-onset hypogonadism.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208458","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":"Summary of the Clinical Practice Guidelines for Male Infertility by the Japanese Urological Association With the Support of the Japan Society for Reproductive Medicine.","authors":"Akira Tsujimura, Masashi Iijima, Yukihiro Umemoto, Hideyuki Kobayashi, Akira Komiya, Koji Shiraishi, Koji Chiba, Yasushi Hirota, Shinichiro Fukuhara, Yasushi Yumura","doi":"10.1111/iju.70132","DOIUrl":"https://doi.org/10.1111/iju.70132","url":null,"abstract":"<p><p>These 2024 guidelines address male infertility amid Japan's declining birth rate, following the recent provision of national health insurance coverage for infertility treatments. Male factors contribute to approximately 50% of infertility cases, with spermatogenic dysfunction being the most common cause (82.4%). The guidelines provide evidence-based recommendations for diagnosing and treating male infertility. Diagnostic approaches include comprehensive medical history, physical examination, semen analysis, hormone testing, genetic testing for severe cases, and appropriate imaging studies. Treatment recommendations cover both medical and surgical interventions. Medical treatments include gonadotropin therapy for hypogonadotropic hypogonadism (grade A), clomiphene citrate for oligozoospermia with low testosterone (grade B), and antioxidant therapy (limited evidence: grade C). Surgical treatments focus on varicocelectomy for palpable varicoceles (grade A), with microsurgical approaches preferred. Nonobstructive azoospermia is treated by microdissection testicular sperm extraction (micro-TESE) (grade A). The guidelines also emphasize preserving fertility before cancer treatment, managing sexual dysfunction with PDE5 inhibitors (grade A), and treating retrograde ejaculation with tricyclic antidepressants (grade B).</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208459","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":"Hesitancy or Straining, That Is the Question: Which Does Question 6 of the International Prostate Symptom Score Represent?","authors":"Noritoshi Sekido, Kenji Omae, Nobuhiro Haga, Yasue Kubota, Motoaki Saito, Ryuji Sakakibara, Mikako Yoshida, Takahiko Mitsui, Naoya Masumori, Satoru Takahashi","doi":"10.1111/iju.70133","DOIUrl":"https://doi.org/10.1111/iju.70133","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the agreement between initial straining, a proxy for Question 6 of the International Prostate Symptom Score (IPSS Q6), and three voiding symptoms (hesitancy, straining during voiding, and terminal straining).</p><p><strong>Participants and methods: </strong>Data from a nationwide survey of lower urinary tract symptoms in adults conducted by the Japanese Continence Society were analyzed. The agreement was evaluated by the weighted kappa coefficient. In addition, the correlation between these four voiding symptoms and other voiding symptoms (slow stream, intermittency, and terminal dribbling) was evaluated by Spearman's rank correlation.</p><p><strong>Results: </strong>Overall, 3122 male and 3088 female participants were included in the analysis. In both male and female groups, substantial agreement on initial straining was observed for hesitancy (kappa, 0.625 and 0.639, respectively) as well as straining during voiding (kappa, 0.790 and 0.801, respectively). Initial straining correlated moderately with other voiding symptoms (rs, 0.442 to 0.597), while hesitancy was moderately correlated with other voiding symptoms (rs, 0.461 to 0.638). Straining during voiding was moderately correlated with intermittency (rs, 0.591 to 0.617).</p><p><strong>Conclusion: </strong>The IPSS Q6 should not be used lightly as either a hesitancy or straining score because it substantially represents both hesitancy and straining during voiding.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208457","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":"This Issue 32–7","authors":"Koji Shiraishi","doi":"10.1111/iju.70143","DOIUrl":"10.1111/iju.70143","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"779-780"},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215790","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 of Double Dorsal Dartos Flap for Urethroplasty Coverage in Distal Hypospadias Repair: A Single Surgeon Approach to Preventing Urethrocutaneous Fistula.","authors":"Nihat Karabacak, Serhat Gürocak, Mustafa Özgür Tan","doi":"10.1111/iju.70135","DOIUrl":"https://doi.org/10.1111/iju.70135","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159028","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}