International Journal of Urology最新文献

{"title":"Stone-Event-Free Survival After Ureteroscopic Lithotripsy According to Residual Fragment Size: Zero Residual Fragment Indicates a Good Prognosis.","authors":"Takashi Tamiya, Ryoji Takazawa, Yuma Waseda, Masaki Kobayashi","doi":"10.1111/iju.70640","DOIUrl":"10.1111/iju.70640","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate how residual renal stone fragment size influences long-term stone-event-free survival after ureteroscopic lithotripsy (URSL), highlighting its clinical importance.</p><p><strong>Methods: </strong>We retrospectively analyzed data from all patients who underwent URSL at our institution from 2008 to 2021. A total of 1334 cases were included and categorized into three groups based on their residual renal fragment size: 0 mm (1030 cases), < 4 mm (214 cases), and ≥ 4 mm (90 cases). Patient characteristics, surgical outcomes, and postoperative stone events were examined. Stone event-free survival rates were compared across these groups.</p><p><strong>Results: </strong>During a mean follow-up of 763 days, 214 patients (16.0%) experienced stone events. The number of stone events in each group was 102 (9.9%) for 0 mm, 57 (26.6%) for < 4 mm, and 55 (61.1%) for ≥ 4 mm. The 1-year stone-event-free rates were 95.8%, 86.9%, and 44.9%, respectively, and the 5-year rates were 81.8%, 51.6%, and 28.0%. The reintervention-free rates at 1 year were 97.4%, 91.7%, and 50.5%, respectively, and at 5 years, they were 86.3%, 61.6%, and 35.5%. The log-rank test indicated significant differences in both stone-event-free and reintervention-free rates among the groups (p < 0.001). The multivariate Cox regression analysis revealed that the size of residual stones (0 mm versus < 4 mm and ≥ 4 mm) was the most significant factor in influencing stone events and re-interventions.</p><p><strong>Conclusions: </strong>The size of residual fragments after URSL significantly influences long-term outcomes, emphasizing the importance of meticulous stone removal for optimal patient care.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70640"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968810","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":"Household Income and Sexual Activity Patterns Among Japanese Men: A Latent Class Analysis of a Nationwide Survey.","authors":"Rie Yoshimura, Nobutaka Shimizu, Keiko Yamasaki, Yoshitaka Kurano, Tsutomu Shimamoto, Satoshi Fukata, Eiji Kikuchi, Kazunori Kimura, Yoshikazu Sato, Koji Chiba, Hikaru Tomoe, Atsushi Nagai, Koichi Nagao, Shinichiro Fukuhara, Tsuyoshi Yoshizawa, Eri Maeda, Masato Shirai, Akira Tsujimura, Haruaki Sasaki, Keiji Inoue, Motoaki Saito","doi":"10.1111/iju.70645","DOIUrl":"10.1111/iju.70645","url":null,"abstract":"<p><strong>Objectives: </strong>To identify latent classes of sexual activity among Japanese adult men using multiple sexual behavior indicators and to investigate their associations with household income.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from a 2023 nationwide Internet-based survey of 5 735 Japanese men aged 20-79 years. Latent class analysis used six indicators: Sexual intercourse frequency, masturbation frequency, morning erection frequency, and International Index of Erectile Function items 6, 11, and 12. Household income data were available for 4 824 men, who were categorized into low (<¥4 million/year), middle (¥4 to <¥8 million/year), or high (≥¥8 million/year) income groups.</p><p><strong>Results: </strong>Four latent classes were identified: Low desire/inactive (Class 1, 37.3%), high desire/non-coital (Class 2, 25.8%), moderate desire/sexually active (Class 3, 14.7%), and high desire/high-function active (Class 4, 22.1%). Higher household income was independently associated with Classes 3 and 4, with dose-response relationships, but not with Class 2. The overall income-by-marital-status interaction was significant (p = 0.0004), whereas the class-specific interaction was significant only for Class 3 (p = 0.021) and not for Class 4 (p = 0.255). These post hoc interaction findings were considered exploratory. Sensitivity analyses yielded consistent results.</p><p><strong>Conclusions: </strong>Approximately one-quarter of Japanese men belonged to a class characterized by moderate-to-high sexual desire and relatively frequent morning erections despite predominantly little or no intercourse. Household income was associated with intercourse-involving classes but not with Class 2. These findings support a multidimensional assessment of sexual health and warrant further research on socioeconomic factors associated with partnered sexual activity.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70645"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030634","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":"Retrospective Single Center Assessment of Routes to Penile Cancer Diagnosis and the Role of Penile Biopsy.","authors":"Christian Raun Boné, Jakob Kristian Jakobsen","doi":"10.1111/iju.70649","DOIUrl":"10.1111/iju.70649","url":null,"abstract":"<p><strong>Objective: </strong>To examine the routes to penile cancer diagnosis and the role of penile biopsy.</p><p><strong>Materials and methods: </strong>This retrospective observational study from a tertiary referral center included 625 patients referred as urgent suspected penile cancer within the Danish Cancer Patient Pathway (CPP) and 216 patients undergoing penile biopsy outside the CPP between January 1, 2021 and March 31, 2025. The main outcomes were the number of patients diagnosed within and outside the CPP and secondary outcomes included biopsy findings, the ratio between urgent suspected penile cancer referrals and the number of patients subsequently diagnosed with penile cancer.</p><p><strong>Results: </strong>Among 529 patients referred under the CPP for suspected penile cancer, only 10% were diagnosed with cancer. Biopsy confirmed cancer was more frequent within the CPP, though overall cancer detection rates were similar (~10%). Patients biopsied outside the CPP were younger and more often had prior biopsies. Complication rates after penile biopsy were low and comparable between groups. Diagnostic concordance between clinical suspicion and histology was slight (κ = 0.20, SE 0.04) for cancer and fair (κ = 0.33, SE 0.05) for PeIN. Biopsies demonstrated both diagnostic and therapeutic value, occasionally altering clinical management.</p><p><strong>Conclusion: </strong>The CPP identifies a higher proportion of malignancies but with a low overall conversion ratio, and some cancers are still diagnosed outside the pathway. Penile biopsy is safe and essential for accurate diagnosis due to low clinical-histological concordance, with added therapeutic value. Continued focused penile biopsy use, including re-biopsy in uncertain cases, is warranted to ensure optimal management and oncological safety.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70649"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037804","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":"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":"Mizuki Onozawa, Masaki Shiota, Taketo Kawai, Shinichi Sakamoto, Yoshiyuki Yamamoto, Satoru Taguchi, Yasuhide Kitagawa, Tohru Nakagawa, Shiro Hinotsu, Jun Miyazaki, Haruki Kume","doi":"10.1111/iju.70642","DOIUrl":"10.1111/iju.70642","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate active surveillance (AS) continuation rates and associated clinical and institutional factors in Japanese patients with localized prostate cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed 989 patients with localized prostate cancer from 92 institutions who initiated AS between 2016 and 2018. Institutions were categorized into three groups based on AS uptake for low-risk disease. Discontinuation triggers and subsequent treatments were examined.</p><p><strong>Results: </strong>Median age was 70 years; 66.2%, 26.0%, and 7.8% of patients had low-, intermediate-, and high-risk disease, respectively. Over a median follow-up of 3.4 years, 47.0% discontinued AS (median AS continuation time: 3.0 years; 5-year AS continuation rate: 33.7%). Multivariable analysis showed that ≥ 2 comorbidities, ≥ 3 positive biopsy cores, and T2b-c stage were associated with restricted mean continuation time differences (RMCTDs) of -0.6, -0.6, and -0.8 years, respectively (all p < 0.05). Conversely, intermediate- and high-AS uptake institutions had significantly longer adjusted RMCTD (1.0 and 1.1 years, respectively; both p < 0.001). Triggers for discontinuation were more often multifaceted in high-AS uptake institutions (39.1%) compared with low- or intermediate-AS uptake institutions (16.2% and 15.1%, respectively). After discontinuation, 36.5%, 39.2%, and 24.3% of patients received prostatectomy, radiotherapy, and hormonal therapy, respectively. With advancing age, the proportion of patients whose AS was discontinued due to PSA elevation increased, as did the rate of subsequent hormonal therapy.</p><p><strong>Conclusions: </strong>In Japanese real-world practice, AS continuation was limited. Beyond clinicopathological factors, institutional strategies for localized prostate cancer played a significant role in treatment choices following AS.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70642"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968786","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":"Distinct Predictors of Early Postoperative and Long-Term Renal Function Decline Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma.","authors":"Shunya Matsumoto, Yuma Waseda, Masaki Kobayashi, Yudai Ishikawa, Hiroshi Fukushima, Yosuke Yasuda, Shohei Fukuda, Hajime Tanaka, Soichiro Yoshida, Yasuhisa Fujii","doi":"10.1111/iju.70643","DOIUrl":"10.1111/iju.70643","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate early postoperative and long-term changes in renal function following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) and to identify factors associated with each phase.</p><p><strong>Methods: </strong>We retrospectively reviewed 168 patients who underwent RNU for UTUC between 2007 and 2022. Renal function was assessed using estimated glomerular filtration rate (eGFR). Early postoperative renal function decline (RFD) was defined as the percentage decrease in eGFR from preoperative values to 1 month post-surgery. Factors associated with early postoperative RFD were evaluated using multivariable linear regression analyses. Long-term RFD was assessed using serial eGFR measurements obtained from 1 month after surgery onward and was analyzed with multivariable linear mixed-effects models.</p><p><strong>Results: </strong>The median follow-up period was 74.5 months. The median preoperative eGFR and early postoperative RFD were 53.1 mL/min/1.73m² and 30.4%, respectively. Multivariable analysis demonstrated that lower clinical stage, absence of hydronephrosis, absence of neoadjuvant chemotherapy, and a preoperative eGFR ≥ 45 mL/min/1.73 m² were independently associated with greater early postoperative RFD. Overall renal function remained relatively stable following the initial postoperative decline. Multivariable analysis identified hypertension and preoperative proteinuria as independent predictors of progressive long-term RFD. Patients with both hypertension and proteinuria experienced greater long-term RFD compared to those with zero or one risk factor.</p><p><strong>Conclusions: </strong>Predictors of early postoperative RFD differed from those of progressive long-term RFD following RNU. These findings suggest that early and long-term postoperative renal functional changes may need to be considered separately in clinical decision-making and patient counseling.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70643"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968752","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":"Stage- and Age-Specific Survival According to Histological Subtype in Renal Cell Carcinoma: A Nationwide Hospital-Based Cancer Registry Analysis in Japan.","authors":"Chihiro Kamijo, Takahiro Osawa, Takuya Moriguchi, Haruka Miyata, Hiroshi Kikuchi, Ryuji Matsumoto, Nobuo Shinohara, Takashige Abe","doi":"10.1111/iju.70639","DOIUrl":"10.1111/iju.70639","url":null,"abstract":"<p><strong>Objective: </strong>To clarify stage- and age-specific overall survival (OS) according to histological subtype among surgically treated patients with RCC in Japan, we analyzed a nationwide hospital-based cancer registry.</p><p><strong>Methods: </strong>We analyzed data from the Japanese nationwide hospital-based cancer registry and identified patients newly diagnosed with RCC between 2012 and 2014. Eligible patients underwent surgical treatment and had histologically confirmed clear cell, papillary, or chromophobe RCC with pathological stage (pStage) I-IV according to the UICC TNM classification, 7th edition. Patients treated with radiotherapy or local ablative therapies were excluded. OS was estimated using the Kaplan-Meier method and compared using the log-rank test.</p><p><strong>Results: </strong>A total of 17 935 patients met the inclusion criteria, including 15 745 clear cell, 1340 papillary, and 850 chromophobe RCC cases. The 5-year OS rates for clear cell, papillary, and chromophobe RCC were 91.2%, 89.7%, and 93.5% at pStage I, and declined to 37.5%, 21.7%, and 59.3% at pStage IV, respectively. Age-stratified analyses in pStage I disease revealed progressively worse OS with advancing age across all histological subtypes. Among patients aged ≥ 85 years, the 5-year OS rates were 68.2% for clear cell, 50.0% for papillary, and 70.0% for chromophobe RCC.</p><p><strong>Conclusions: </strong>This nationwide registry-based study provides updated real-world evidence on survival patterns in RCC in Japan. Advanced age was associated with reduced OS even in patients with pStage I disease, highlighting the importance of considering age when interpreting overall survival in surgically treated patients with RCC.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70639"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968758","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":"Treatment Patterns and Outcomes After Recurrence Following Adjuvant Nivolumab for Urothelial Carcinoma: An AGEHA Real-World Study.","authors":"Izuki Ogawa, Takuma Narita, Masanao Shinohara, Yohei Kawashima, Yuya Sekine, Shintaro Narita, Shin Kobayashi, Noriyuki Abe, Shunsuke Tazawa, Naoki Fujita, Jotaro Mikami, Teppei Okamoto, Hayato Yamamoto, Kazuyuki Numakura, Satoshi Sato, Tomonori Habuchi, Chikara Ohyama, Shingo Hatakeyama","doi":"10.1111/iju.70636","DOIUrl":"10.1111/iju.70636","url":null,"abstract":"<p><strong>Objectives: </strong>To describe post-recurrence treatment patterns and outcomes after adjuvant nivolumab for urothelial carcinoma in real-world practice.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with urothelial carcinoma who underwent radical cystectomy or nephroureterectomy followed by adjuvant nivolumab in the multicenter AGEHA database. Among 141 patients, 40 developed recurrence, excluding non-muscle-invasive bladder recurrence. First-line post-recurrence treatment was categorized as enfortumab vedotin plus pembrolizumab (EVP), enfortumab vedotin (EV), non-EV regimens, or no systemic therapy. Overall survival (OS) was measured from recurrence and progression-free survival (PFS) from initiation of first-line post-recurrence therapy.</p><p><strong>Results: </strong>Of 141 patients treated with adjuvant nivolumab, 40 (28%) developed recurrence. First-line post-recurrence treatment was EVP in 10 patients, EV in 15, non-EV regimens in 12, and no systemic therapy in 3. Median time from surgery and nivolumab initiation to recurrence was 5.9 and 4.2 months, respectively. Median OS from recurrence was 27.1, 26.0, and 23.4 months in the EVP, EV, and non-EV groups, respectively, while median PFS from initiation of first-line post-recurrence therapy was 12.9, 7.6, and 8.7 months. Baseline characteristics differed across groups, particularly in recurrence timing and metastatic sites, and EV-based therapy was frequently selected after recurrence.</p><p><strong>Conclusions: </strong>Recurrence after adjuvant nivolumab occurred in 28% of patients in real-world practice. Post-recurrence management was heterogeneous, and EV-based therapy was frequently used in this setting. These findings provide hypothesis-generating real-world evidence on treatment sequencing after adjuvant nivolumab and require validation in larger cohorts with longer follow-up.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70636"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968307","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":"Implementation of Systematic Fourth-Arm Traction and Articulating-Needle Drivers in Senhance Robotic Radical Prostatectomy: Initial Experience.","authors":"Zenkichi Sekiguchi, Masahide Sasaki, Kaori Matsumura, Yoshitsugu Sato, Sakurako Tomokiyo, Ryuto Nakazawa, Eiji Kikuchi","doi":"10.1111/iju.70644","DOIUrl":"10.1111/iju.70644","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the impact of incorporating systematic fourth-arm traction and articulating-needle drivers on the perioperative and oncological outcomes of Senhance robotic radical prostatectomy.</p><p><strong>Methods: </strong>We conducted a retrospective single-center analysis of 30 consecutive patients who underwent Senhance robotic radical prostatectomy procedures between October 2024 and December 2025. The patients were stratified into an initial cohort (cases 1-15), which underwent surgery using a three-arm robotic configuration and conventional straight needle drivers, and a refined cohort (cases 16-30), in which continuous fourth-arm traction and articulating-needle drivers were used. The primary endpoints were operative time and positive surgical margin rate.</p><p><strong>Results: </strong>The median operative time decreased significantly, from 260 min in the initial cohort to 200 min in the refined cohort (p < 0.01). This figure was further reduced, from 244 to 194 min (p < 0.01), after all cases involving lymphadenectomy were excluded. The positive surgical margin rate showed a non-significant trend toward reduction from 33% to 7% (p = 0.17). Early urinary continence was also evaluated as an initial functional outcome, with no significant difference between the two cohorts. A learning curve analysis demonstrated a progressive improvement in operative efficiency (R² = 0.57, p < 0.01). No major complications (Clavien-Dindo grades ≥ III) occurred in either cohort.</p><p><strong>Conclusions: </strong>The refined protocol was associated with shorter operative time and a non-significant trend toward a lower positive surgical margin rate. These findings should be interpreted cautiously, as our refinement of the surgical protocol overlapped with the learning curve of the surgeon who performed the procedures.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70644"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976759","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":"Global Adoption of Transcontinental Telesurgery: Are We There Yet?","authors":"Saad Aldousari, Ahmad N Almarzouq, Abdelkareem Hassan, Ahmed Shahin, Abdulrahman H Almazeedi, Basmah Bahbahani","doi":"10.1111/iju.70647","DOIUrl":"10.1111/iju.70647","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70647"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968771","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":"Sexual Dysfunction and Lower Urinary Tract Dysfunction in Adults With Spina Bifida.","authors":"Daisuke Gotoh, Akira Tachibana, Yuki Oda, Mitsuru Tomizawa, Kenta Onishi, Shunta Hori, Yosuke Morizawa, Yasushi Nakai, Makito Miyake","doi":"10.1111/iju.70635","DOIUrl":"10.1111/iju.70635","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate sexual function and lower urinary tract dysfunction in adults with spina bifida (SB) compared with healthy controls and their impact on quality of life (QOL).</p><p><strong>Methods: </strong>In this prospective observational study, 30 adults with SB (21 women, 9 men) and 28 healthy volunteers (17 women, 11 men) were enrolled (September 2023-December 2024). Sexual and urinary function were assessed with the FSFI, SHIM, IPSS, Overactive Bladder Symptom Score, ICIQ-SF, and King's Health Questionnaire. Group differences were analyzed with Mann-Whitney U or chi-square tests with Benjamini-Hochberg correction; effect sizes were reported as rank-biserial r or Cramér's.</p><p><strong>Results: </strong>Patients with SB had significantly poorer sexual and lower urinary tract function than controls. In women, sexual desire was relatively preserved (q = 0.21, r = 0.20), whereas arousal, lubrication, orgasm, and satisfaction were markedly reduced (all q ≤ 0.003, r = 0.51-0.79). In men, erectile function was severely impaired (SHIM total 3.0 vs. 21.0; q = 0.0006, r = 0.81). IPSS and ICIQ-SF totals were higher in the SB group in both sexes (all q ≤ 0.0004, r ≥ 0.79). IPSS-QOL correlated with ICIQ-SF in both women (Spearman r = 0.57, p = 0.009) and men (r = 0.80, p = 0.011).</p><p><strong>Conclusions: </strong>Adults with SB had substantial sexual and lower urinary tract dysfunction. Sexual desire was relatively preserved in women, whereas urinary incontinence was associated with poorer QOL.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 9","pages":"e70635"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968777","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}