International Journal of Urology最新文献

{"title":"Double-Sided Heinecke-Mikulicz Urethroplasty for Short Stricture Around Penoscrotal Junction: Description of Technique and Clinical Outcome of Initial Cases.","authors":"Akihiro Kanematsu, Toeki Yanagi, Kimihiro Shimatani, Motohiro Taguchi, Shingo Yamamoto","doi":"10.1111/iju.70108","DOIUrl":"https://doi.org/10.1111/iju.70108","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to describe and clinically review a new surgical technique for treating short stricture around the penoscrotal junction: Double-sided Heinecke-Mikulicz urethroplasty using a ventral approach.</p><p><strong>Patients and methods: </strong>The study included 11 patients aged 22-83 years affected by urethral strictures around the penoscrotal junction 3-20 mm in length, resulting from transurethral procedures (n = 6), hypospadias repair (n = 3), and trauma (n = 2). The urethra was approached by transperineal penile invagination in eight cases and by penile incision in three cases. In five cases with longer strictures, the distal to mid-bulbar urethra was circumferentially mobilized to avoid anastomotic tension. A ventral midline urethral incision was made from the outside, encompassing the stricture, and the dorsal wall was also incised in the midline from the luminal side. The dorsal incision was sutured longitudinally from the luminal side, and the ventral incision was closed longitudinally from the outside, completing the Heinecke-Mikulicz technique in the dorsal and ventral urethral walls.</p><p><strong>Results: </strong>The operation time was 92-166 min (median 125 min), and the postoperative observation period was 18-39 months (median 33 months). Two patients developed stricture recurrence, while durable success was achieved in the other nine patients (81.8%). Three patients reported slight penile shortening, but without impairment in sexual activity in Sexual Health Inventory for Men questionnaires.</p><p><strong>Conclusions: </strong>The present study reports a simple and useful non-transecting urethroplasty technique without using substitutive tissue for treating short urethral strictures around the penoscrotal junction.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077066","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":"Survivorship Post-Retroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer: A Systematic Review.","authors":"Gavin G Calpin, Niall J O'Sullivan, Cian Hehir, Arun Z Thomas, Rowan G Casey","doi":"10.1111/iju.70109","DOIUrl":"https://doi.org/10.1111/iju.70109","url":null,"abstract":"<p><strong>Introduction: </strong>Retroperitoneal lymph node dissection (RPLND) may be considered after chemotherapy or as primary treatment in patients with metastatic testicular cancer. We aimed to perform a systematic review to analyze outcomes in survivors across the domains of sexual, physical, and psychological function. It is the first systematic review of outcomes of survivorship following RPLND.</p><p><strong>Methods: </strong>A systematic review was performed as per PRISMA guidelines. Outcomes were extracted from studies meeting the inclusion criteria and were analyzed.</p><p><strong>Results: </strong>In total, there were 11 studies included with 1086 patients. Of these, 80.5% had stage 1 disease and 63.1% had nerve-sparing surgery. Clavien-Dindo 1-2 post-operative complications were reported in 14.1% of cases and Clavien-Dindo 3-5 in 4.5%. There was a 7.0% recurrence rate. Sexual impairment including hypospermia, dry ejaculation, and erectile dysfunction was more prevalent among patients who had non-nerve-sparing procedures. Primary robotic surgery was reported to decrease the systemic chemotherapy burden in patients. Physical, emotional, social functioning, and global quality of life were significantly better in minimally invasive surgery compared to open RPLND.</p><p><strong>Conclusion: </strong>RPLND is a viable treatment approach and may be considered at multidisciplinary discussions for patients with metastatic testicular cancer. Minimally invasive surgery appears to have better sexual, physical, and psychological outcomes compared to open surgery, with low rates of perioperative complications and acceptable early oncologic outcomes. However, these patients may have been carefully selected and, therefore, are more likely to have favorable outcomes. Sexual dysfunction is a possible complication, and patients should be thoroughly counseled about the risks and benefits of RPLND.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077875","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":"Correction to \"Clinical Manifestations of Interstitial Cystitis and Bladder Pain Syndrome: Analysis of a Patient Registry in Japan\".","authors":"","doi":"10.1111/iju.70094","DOIUrl":"https://doi.org/10.1111/iju.70094","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076967","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":"Role and Efficacy of Percutaneous 4.5-Fr Semi-Rigid Ureteroscope While Creating Through-And-Through Guidewire Passage During Minimally Invasive Endoscopic Combined Intrarenal Surgery in the Supine Position; Retrospective Study at a Single Institution.","authors":"Takaaki Inoue, Shuzo Hamamoto, Shinsuke Okada, Naoto Tanaka, Fukashi Yamamichi, Masaichiro Fujita, Hideaki Miyake","doi":"10.1111/iju.70099","DOIUrl":"https://doi.org/10.1111/iju.70099","url":null,"abstract":"<p><strong>Objective: </strong>This study was performed to evaluate the efficacy of using a percutaneous 4.5-Fr semi-rigid ureteroscope (4.5-rURS) and preoperative clinical factors in the performance of the through-and-through guidewire technique (T&TGW) under the guidance of retrograde flexible ureteroscope (fURS)-assisted fluoroscopy during minimally invasive endoscopic combined intrarenal surgery (mini-ECIRS).</p><p><strong>Methods: </strong>In total, 123 patients who underwent mini-ECIRS with percutaneous 4.5-rURS assistance for large kidney stones in the flank-free modified Valdivia position were retrospectively evaluated. The primary outcome was the achievement rate of T&TGW, defined as percutaneous insertion of a guidewire that passed down the ureter and exited outside the external urethral meatus. The secondary outcome was the rate of percutaneous 4.5-rURS assistance required to successfully perform T&TGW.</p><p><strong>Results: </strong>The stone-free rate was 81.2%, including no residual fragments in 72.3% of patients. T&TGW was successful in 119 (96.6%) patients, which was necessary using retrograde fURS-assisted fluoroscopic guidance in 61 (49.5%) patients, whereas 4.5-rURS assistance was required in 58 (47.1%) patients. Guidewire migration under the renal pelvis mucosa was found in 10 (8.1%) patients. Preoperative factors associated with failed T&TGW using retrograde fURS-assisted fluoroscopic guidance were the puncture site in the lower calyx (odds ratio, 0.125; confidence interval, 0.043-0.364; p = 0.001) and the presence of preoperative hydronephrosis in the renal calyx of the puncture site (odds ratio, 0.261; confidence interval, 0.093-0.730; p = 0.011).</p><p><strong>Conclusion: </strong>Percutaneous 4.5-rURS assistance facilitated successful T&TGW in cases of failed access under retrograde fURS-assisted fluoroscopic guidance in supine mini-ECIRS and a useful option to find a migrated guidewire in the wrong direction.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017415","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":"Penile Cancer: Differences Between Patients Over and Under the Age of 75 Years.","authors":"Yoji Murakami, Takahiro Yamaguchi, Masato Goya, Katsuyoshi Higashijima, Shohei Tobu, Ryuta Sato, Shuichi Tatarano, Shoichiro Mukai, Kei-Ichiro Uemura, Katsunori Tatsugami, Kazuna Tsubouchi, Yohei Shida, Tatsu Ishii, Hideki Sakai, Hirofumi Matsuoka, Nobuhiro Haga, Masatoshi Eto, Tsukasa Igawa, Toshiyuki Kamoto, Hideki Enokida, Toshitaka Shin, Mitsuru Noguchi, Naohiro Fujimoto, Seiichi Saitoh, Tomomi Kamba","doi":"10.1111/iju.70090","DOIUrl":"https://doi.org/10.1111/iju.70090","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate differences in patient characteristics, treatment, and cancer-specific survival between penile cancer patients aged 75 years or older and those younger than 75 years.</p><p><strong>Methods: </strong>One hundred ninety-six patients with penile cancer who were treated in 12 hospitals in the Kyushu-Okinawa region from 2009 to 2020 were retrospectively analyzed.</p><p><strong>Results: </strong>The older (age ≥ 75 years) and younger (age < 75 years) groups comprised 80 and 116 patients, respectively. Among all patients with clinical stage 3 disease and those with stage 3A alone, cancer-specific survival was significantly worse in the older group. Patients in the older group exhibited worse Eastern Cooperative Oncology Group Performance Status scores, lower albumin concentrations, and higher neutrophil-to-lymphocyte ratios. Treatment intensity was lower in the older patients, but the findings were not significant: partial penile resection was predominant in the older group, while patients in the younger group more frequently underwent total penile resection. In addition, pelvic lymph node dissection was less frequently performed in the older group.</p><p><strong>Conclusions: </strong>Among patients with clinical stage 3 penile cancer, cancer-specific survival was worse in those aged 75 years or older. Worse Eastern Cooperative Oncology Group Performance Status scores and less aggressive treatment in the older group may have been contributing factors.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989811","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":"Two-Stage Repair for re-do Hypospadias: Results of Over 5-Year Follow-Up.","authors":"Orhan Ziylan, Ismail Selvi, Muhammet İrfan Dönmez, Ahmet Barış Aydın, Tayfun Oktar","doi":"10.1111/iju.70098","DOIUrl":"https://doi.org/10.1111/iju.70098","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the postoperative complications, reintervention rates, as well as long-term urinary and cosmetic outcomes in our patients who underwent two-stage re-do hypospadias repair.</p><p><strong>Methods: </strong>Files of 122 boys who underwent two-stage surgery for re-do hypospadias repair between June 2001 and October 2017 with > 5 years of follow-up were retrospectively reviewed. Demographics, preoperative clinical characteristics, postoperative complications, uroflowmetry findings, the Penile Perception Score (PPS), and the Hypospadias Objective Scoring Evaluation (HOSE) score at the last clinical visit were noted.</p><p><strong>Results: </strong>Patients had undergone a median 2 (range 1-8) prior surgeries. Of these patients, 46.7% had mid penile hypospadias with a poor urethral plate/uncorrectable chordee, 44.3% had penoscrotal hypospadias, and 9% had scrotal or perineal hypospadias. Lower lip (78, 63.9%), a combination of cheek and lower lip (21, 17.2%), cheek (14, 11.5%), and upper lip (9, 7.4%) were the donor sites for the graft. After a median 121 (range 66-204) months of follow-up, the overall complication rate was 36.8%, and 23.8% required further intervention. Glans dehiscence (12.3%) was the most common complication, followed by urethrocutaneous fistula (10.7%), meatal stenosis (10.7%), residual chordee (6.6%), buried penis or skin deformities (6.6%), distal urethral dehiscence (4.9%), graft contracture after first stage (2.5%), urethral stricture (1.6%), complete urethral dehiscence (0.8%), and urethral diverticulum (0.8%). Median interval from second-stage repair to the repeat intervention for complications was 10 (range 4-30) months. According to the HOSE and PPS, almost 90% of the patients denoted functional and cosmetically acceptable outcomes.</p><p><strong>Conclusion: </strong>Two-stage repair is a viable alternative for the most challenging re-do hypospadias cases, with almost 90% satisfaction and a quarter requiring reintervention.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989812","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":"Application of Urethral-Plate Longitudinal Incision in Mathieu Repair for Hypospadias Reoperation.","authors":"Xin Yu, Zhao-Xia Liu, Cao Yang","doi":"10.1111/iju.70097","DOIUrl":"https://doi.org/10.1111/iju.70097","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the efficacy and complication rates of urethral-plate longitudinal incision combined with Mathieu repair versus tubularized incised plate (TIP) in the reoperation of hypospadias.</p><p><strong>Method: </strong>This study retrospectively analyzed 46 patients with subcoronal urethral fistula and glans dehiscence after hypospadias operation in our hospital from February 2021 to March 2023. It has been 6-56 months since the initial operation. For the selected patients with subcoronal fistula, the tissues from the fistula to the urethral orifice were cut in the membranous or skin bridge shape. Meanwhile, all patients were divided into two groups, including group A and group B. Group A (n = 19) received the urethral-plate longitudinal incision combined with Mathieu repair. Group B (n = 27) adopted conventional TIP repair. The complication rate and urethral orifice shape were compared between the two groups.</p><p><strong>Result: </strong>In terms of postoperative follow-up, there were three cases with complications in group A and 12 in group B, and the difference was statistically significant (p = 0.041). With regard to urethral orifice, no case in group A and seven cases in group B had urethral orifice, and the difference was statistically significant (p = 0.036). Except for glans dehiscence, all cases with urethral orifice in both groups had a fissured appearance.</p><p><strong>Conclusion: </strong>As an effective approach to repair glans dehiscence and subcoronal fistula after hypospadias operation, urethral-plate longitudinal incision combined with Mathieu helps to further expand the urethral orifice and form a reasonable vertical fissured urethral orifice. Institutional Reviewer Board: IRB:EYLL-2023-006.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017163","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":"Translational Research Bridging Basic and Clinical Insights in Renal Cell Carcinoma: A Collaborative Review and Future Directions.","authors":"Ryosuke Jikuya, Akihiko Fukagawa, Daisuke Ito, Hiroki Ishihara, Kosuke Takemura, Soki Kashima, Taigo Kato, Fumihiko Urabe","doi":"10.1111/iju.70091","DOIUrl":"https://doi.org/10.1111/iju.70091","url":null,"abstract":"<p><p>Despite significant progress in the diagnosis and treatment of renal cell carcinoma (RCC), approximately 20% of patients present with metastatic disease, and up to 30% of patients with localized tumors experience recurrence following nephrectomy. Although immune checkpoint inhibitors (ICIs) and vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) have improved clinical outcomes, treatment resistance and refractoriness remain critical challenges. Genomic profiling has identified alterations in several kidney cancer-associated genes, including VHL and chromatin remodeling genes, refining the classification of RCCs and revealing novel therapeutic targets such as hypoxia-inducible factor (HIF)-2α and metabolic pathways. Immunologically, RCCs exhibit trends opposite to those observed in other types of cancer, such as melanoma and lung cancer, in that high tumor mutation burden and high CD8+ T cell infiltration in RCCs do not predict better responses to ICIs. Combination therapies integrating ICIs and VEGFR-TKIs have shown greater treatment efficacy, but overcoming immune resistance remains an urgent priority. Liquid biopsy technologies, including assays of circulating tumor DNA and extracellular vesicles, are emerging as minimally invasive tools for early detection, treatment monitoring, and recurrence prediction. Liquid biopsy approaches that Integrate genomic and transcriptomic profiling may provide comprehensive tumor characterization and suggest personalized treatment strategies. This review explores recent advances in basic and translational research, emphasizing genomic analyses, dissection of tumor-immune microenvironments, and liquid biopsy techniques that can reshape RCC diagnostics and therapeutics. Multidisciplinary collaboration supported by high-quality biospecimens and robust clinical datasets is essential to advance translational research and improve patient outcomes.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063730","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":"Association Between Overactive Bladder and Sarcopenia in Older Adults: A Population-Based Cohort Study.","authors":"Suguru Ito, Mayu Yagi, Kaori Sakurada, Sei Naito, Hayato Nishida, Atsushi Yamagishi, Hidenori Kanno, Takafumi Narisawa, Hiroki Fukuhara, Yuki Takai, Satoshi Takai, Tsuneo Konta, Satoru Nagase, Norihiko Tsuchiya","doi":"10.1111/iju.70088","DOIUrl":"https://doi.org/10.1111/iju.70088","url":null,"abstract":"<p><strong>Background: </strong>To explore the association between overactive bladder (OAB) and sarcopenia in older adults using a questionnaire-based, population-based cohort study.</p><p><strong>Methods: </strong>The Overactive Bladder Symptom Score (OABSS) and Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaires were mailed to residents in several areas of Yamagata Prefecture from 2021 to 2022. OAB was defined according to International Continence Society criteria, and sarcopenia was identified using the SARC-F questionnaire.</p><p><strong>Results: </strong>In total, 9008 respondents aged ≥ 65 years who fully completed the questionnaires were included (3798 men, 5210 women; median age, 74 years). OAB was present in 27% of participants and was significantly more common in men (34% vs. 23%, p < 0.001). Sarcopenia was observed in 12% of participants, with a higher prevalence in women (13% vs. 10%, p < 0.001). In the univariable analysis, the presence of OAB was significantly associated with all SARC-F items, and sarcopenia was similarly associated with all OABSS items. In the age- and sex-adjusted multivariable analysis, OAB was significantly associated with all SARC-F items except \"assistance with walking.\" Sarcopenia was associated with all OABSS items except \"frequency,\" while falls were significantly associated only with the OABSS items \"nocturia\" and \"urgency urinary incontinence\" (UUI).</p><p><strong>Conclusions: </strong>This is the first large, population-based cohort study to investigate the association between OAB and sarcopenia screened with SARC-F. A strong association between the two conditions was observed, with particular risk for falls suggested in relation to nocturia and UUI.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035210","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 \"Is Docetaxel Essential for Darolutamide-Based Metastatic Hormone-Sensitive Prostate Cancer Therapy?\"","authors":"Koji Hatano","doi":"10.1111/iju.70093","DOIUrl":"https://doi.org/10.1111/iju.70093","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012024","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}