International Journal of Urology最新文献

{"title":"Editorial Comment: Adjustment to an Appropriate Bedtime Improves Nocturia in Older Adults: A Crossover Study","authors":"Tomohiro Matsuo,&nbsp;Ryoichi Imamura","doi":"10.1111/iju.70095","DOIUrl":"10.1111/iju.70095","url":null,"abstract":"<p>This study by Okumura et al. [<span>1</span>] offers a novel behavioral strategy to manage nocturia in older adults by adjusting bedtime based on wearable sleep–wake data. It is a timely and well-designed study that addresses a common, quality-of-life-reducing issue in geriatric care.</p><p>The standout feature is the use of a personalized bedtime algorithm, based on actigraphy and the steepest descent method. By correcting sleep timing, the authors achieved measurable improvements in nocturnal urinary frequency (NUF), nocturnal urine volume (NUV), and sleep quality [<span>1</span>]. This intervention avoids medication-related risks, such as falls or cognitive side effects, which are especially concerning in older populations. The crossover design with a washout period strengthens the validity of results. The significant changes in hours of undisturbed sleep (HUS) and reduced NUV per hour further suggest that personalized sleep timing could meaningfully reduce nocturia symptoms.</p><p>The small sample size (<i>n</i> = 24) limits generalizability. All participants were Japanese, and cultural or lifestyle factors may influence outcomes. Although the authors discuss hormonal involvement (e.g., melatonin, aldosterone), no biochemical data were collected. Prior studies have shown that behavioral sleep interventions can reduce NUF in older adults with insomnia [<span>2</span>], and that personalized sleep modeling from actigraphy can yield accurate estimations [<span>3</span>]. Melatonin levels are also relevant. Reduced secretion has been linked with nocturia, and exposure to daylight may enhance its production [<span>4</span>]. Sleep restriction has been associated with suppressed renin-angiotensin-aldosterone activity, possibly contributing to nocturnal polyuria [<span>5</span>].</p><p>This approach can potentially be expanded to broader groups, such as those with overactive bladder or circadian rhythm disorders. Incorporating such strategies into mobile health apps could offer scalable, drug-free management options. More research is needed to explore the physiological mechanisms involved and long-term adherence.</p><p>Okumura et al. [<span>1</span>] demonstrate that a simple, personalized, non-pharmacologic intervention can significantly improve nocturia and sleep quality in older adults. Their findings provide a promising step forward in behavioral urology and digital health.</p><p><b>Tomohiro Matsuo:</b> writing – original draft, review, and editing. <b>Ryoichi Imamura:</b> editing and supervision.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"877-878"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996652","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":"Serum Lactate Dehydrogenase Level Prior to First-Line Chemotherapy for Metastatic Urothelial Carcinoma Is a Prognostic Factor for Avelumab Maintenance Therapy: A Multicenter Retrospective Study.","authors":"Takahito Wakamiya, Shimpei Yamashita, Yasuo Kohjimoto, Isao Hara","doi":"10.1111/iju.70086","DOIUrl":"https://doi.org/10.1111/iju.70086","url":null,"abstract":"<p><strong>Objectives: </strong>We investigate the association between serum lactate dehydrogenase and prognosis in patients with urothelial carcinoma who were treated with avelumab maintenance therapy in combination with other biomarkers.</p><p><strong>Methods: </strong>We identified 54 patients with advanced or metastatic urothelial carcinoma that received avelumab maintenance therapy between June 2021 and February 2024 at our institutions. We retrospectively analyzed progression-free survival and overall survival from the initiation of avelumab maintenance therapy. Best overall response was evaluated based on the RECIST guidelines v1.1. To investigate factors potentially associated with response to avelumab maintenance therapy and overall survival, we conducted an assessment of markers that have been previously reported as prognostic factors, including urothelial carcinoma and other cancers.</p><p><strong>Results: </strong>The median overall survival by best overall response of first-line chemotherapy was not reached for complete response, partial response, or 15-month stable disease (p = 0.27). As for avelumab maintenance therapy, median overall survival by best overall response was not reached for complete response, partial response, and not evaluable; it was 18 months for stable disease and 13 months for progressive disease, with significant differences (p = 0.04). In multivariable analysis, lactate dehydrogenase level below the upper limit of normal prior to first-line chemotherapy was a significant independent factor in predicting disease control rate (p < 0.01) and overall survival (p = 0.04) in avelumab maintenance therapy.</p><p><strong>Conclusions: </strong>Normal serum lactate dehydrogenase level prior to first-line chemotherapy was a significant predictor of favorable response or prognosis for avelumab maintenance therapy in our cohort.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023664","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 “Peritumoral Infiltration of Regulatory T Cells Reduces the Therapeutic Efficacy of Bacillus Calmette–Guérin Therapy for Bladder Carcinoma In Situ”","authors":"Kimiharu Takamatsu","doi":"10.1111/iju.70089","DOIUrl":"10.1111/iju.70089","url":null,"abstract":"<p>Carcinoma in situ (CIS) of the bladder is an aggressive form of non-muscle-invasive bladder cancer (NMIBC) with a high potential for progression to muscle-invasive bladder cancer (MIBC) and metastasis. Intravesical instillation of Bacillus Calmette–Guérin (BCG) immunotherapy is the standard treatment for high-risk and intermediate-risk papillary NMIBC, as well as for CIS. However, patients treated with BCG exhibit a recurrence rate of 40%–60% and a progression rate of 9.5%–23.4%, highlighting the need for optimized therapeutic strategies, including timely aggressive interventions such as radical cystectomy and novel immuno-oncology agents [<span>1</span>]. Despite its widespread use, randomized controlled trials (RCTs) for BCG-resistant CIS remain insufficient, and clear guidelines for oncological decision-making and follow-up scheduling are still lacking [<span>2</span>]. Establishing precise biomarkers is essential for the future of precision medicine.</p><p>In this study, Fukiage et al. investigated the relationship between FOXP3 + density, the FOXP3+/CD4+ cell density ratio within 20 μm of the lower edge of bladder CIS, and the response to BCG treatment [<span>3</span>]. The authors focused on FOXP3+ cells, a marker for regulatory T cells (Tregs), in close proximity to CIS cancer cells and proposed that Tregs enrichment adjacent to CIS could serve as a biomarker at the time of CIS diagnosis, prior to BCG instillation. While previous studies have associated Tregs with treatment resistance in BCG-treated CIS [<span>4</span>], this study highlights the significant influence of peritumoral Tregs on oncological outcomes. Interestingly, in this cohort, metastases were observed exclusively in the high Tregs near CIS group, although the difference did not reach statistical significance. BCG treatment can lead to two distinct immune microenvironments: an immunosuppressive microenvironment, which is associated with poor prognosis, and an immune-enhanced microenvironment, characterized by high CD8+ T cell infiltration, which correlates with favorable outcomes [<span>5</span>]. Although this study did not investigate the mechanisms by which Tregs adjacent to CIS interact with cancer cells during BCG treatment, their peritumoral distribution may serve as a surrogate biomarker for immune microenvironmental profiling for predicting resistance to BCG therapy and could inform the design of clinical trials.</p><p>Larger prospective cohort studies and further validation studies are required to clarify the role of Tregs in BCG resistance and determine whether their effects can be modulated through additional cancer immunotherapies. If validated, assessing Treg distribution could become a valuable tool in clinical urology.</p><p><b>Kimiharu Takamatsu:</b> conceptualization, writing – original draft, writing – review and editing.</p><p>The author declares no conflicts of interest.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 6","pages":"747-748"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982653","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 to “Tertiary Lymphoid Structures Correlate With Better Prognosis in Patients With Retroperitoneal Sarcoma: A Retrospective Study”","authors":"Yoshiyuki Yamamoto,&nbsp;Norio Nonomura","doi":"10.1111/iju.70092","DOIUrl":"10.1111/iju.70092","url":null,"abstract":"&lt;p&gt;I read with great interest the article by Kijima et al. [&lt;span&gt;1&lt;/span&gt;], which explores the prognostic value of intratumoral tertiary lymphoid structures (TLSs) in retroperitoneal sarcomas, particularly focusing on dedifferentiated liposarcoma (DDLPS). This study provides valuable insights into the tumor immune microenvironment of a rare and biologically heterogeneous malignancy, emphasizing the emerging role of TLSs as prognostic biomarkers.&lt;/p&gt;&lt;p&gt;The authors conducted a retrospective analysis of 29 patients who underwent curative-intent surgery for retroperitoneal sarcoma. TLSs were identified in 59% of cases, and their presence, particularly when ≥ 10 per 100 mm&lt;sup&gt;2&lt;/sup&gt;, correlated with significantly prolonged disease-specific survival. Notably, this favorable impact was observed most robustly in patients with DDLPS. Multivariate Cox analysis confirmed TLS negativity as an independent poor prognostic factor (hazard ratio 3.1, 95% confidence interval 1.4–8.1, &lt;i&gt;p&lt;/i&gt; = 0.02), alongside R2 resection margins [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;These findings are consistent with recent studies in soft tissue sarcoma suggesting that TLSs function as localized and organized immune hubs where B and T lymphocytes interact to initiate anti-tumor responses [&lt;span&gt;2&lt;/span&gt;]. The association of high TLS density with increased infiltration of CD8&lt;sup&gt;+&lt;/sup&gt; T cells, as shown in this study [&lt;span&gt;1&lt;/span&gt;], supports the immunologically active phenotype of TLS-positive tumors. In retroperitoneal sarcomas, where response to chemotherapy is often limited [&lt;span&gt;3&lt;/span&gt;], the presence of TLSs may reflect an intrinsic immunogenicity that could be leveraged therapeutically.&lt;/p&gt;&lt;p&gt;Particularly noteworthy is the study's implication that TLSs may not only reflect the underlying immune microenvironment but may also serve as a predictive biomarker for immunotherapy. The SARC028 trial demonstrated that sarcomas with high levels of tumor-infiltrating lymphocytes respond favorably to immune checkpoint inhibitors (ICIs) [&lt;span&gt;4&lt;/span&gt;]. Moreover, the PEMBROSARC [&lt;span&gt;5&lt;/span&gt;] trial showed that sarcomas rich in tertiary lymphoid structures (TLSs) also respond well to ICIs [&lt;span&gt;5&lt;/span&gt;]. In the current cohort, one TLS-positive patient with high tumor mutational burden and microsatellite instability achieved a durable complete response to pembrolizumab, underscoring this potential [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Despite the small sample size and limitations of a single-institution retrospective design, the authors' robust immunohistochemical characterization of TLSs—including CD21&lt;sup&gt;+&lt;/sup&gt; follicular dendritic cell staining—adds methodological strength. Evaluating TLS density as a stratified continuous variable further enhances its clinical utility. Future studies should aim to integrate spatial transcriptomics or multiplex imaging to better dissect TLS functional heterogeneity.&lt;/p&gt;&lt;p&gt;This study highlights the potential of TLSs as prognostic and possibly predictive biomarker","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"868-869"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995895","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":"Effects of Robot-Assisted Radical Cystectomy on Peritoneal Carcinomatosis and Prognosis in Patients With Muscle-Invasive Bladder Cancer: A Multicenter Retrospective Study.","authors":"Fumiya Yoneyama, Masanao Shinohara, Yohei Kawashima, Anna Yoneyama, Noritaka Ishii, Takuya Oishi, Ryuma Tanaka, Hikari Miura, Hirotake Kodama, Naoki Fujita, Teppei Okamoto, Hayato Yamamoto, Takahiro Yoneyama, Satoshi Sato, Chikara Ohyama, Shingo Hatakeyama","doi":"10.1111/iju.70087","DOIUrl":"https://doi.org/10.1111/iju.70087","url":null,"abstract":"<p><strong>Objectives: </strong>We compared the effects of robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC) on the incidence of peritoneal carcinomatosis and prognosis in patients with muscle-invasive bladder cancer (MIBC) in real-world practice.</p><p><strong>Methods: </strong>This retrospective study included 429 patients who underwent radical cystectomy, including RARC (n = 151) and ORC (n = 278), at Hirosaki University Hospital and Ageo Central General Hospital from 2011 to 2024. The incidence of peritoneal carcinomatosis was compared between the RARC and ORC groups. Potential risk factors for peritoneal carcinomatosis were identified using multivariable logistic regression analysis. The impact of peritoneal carcinomatosis on overall survival was evaluated using the Kaplan-Meier method and multivariable Cox regression analysis.</p><p><strong>Results: </strong>The incidence of peritoneal carcinomatosis was low and not significantly different between the ORC (n = 13, 4.7%) and RARC (n = 6, 4.0%) groups. Multivariate logistic regression analysis revealed that clinical high-risk (cT3-4 or cN+) was significantly associated with an increased risk of peritoneal carcinomatosis (odds ratio: 5.03, 95% confidence interval 1.34-18.8, p = 0.016) after ORC but not RARC. Neoadjuvant chemotherapy significantly reduced the risk of peritoneal carcinomatosis. Recurrence-free and overall survival were similar between RARC and ORC in patients with peritoneal carcinomatosis. Multivariate Cox regression analyses showed that pathological high-risk and peritoneal carcinomatosis but not RARC were significantly associated with poor overall survival.</p><p><strong>Conclusions: </strong>No significant differences in the atypical recurrence pattern of peritoneal carcinomatosis were detected between RARC and ORC. Neoadjuvant chemotherapy may reduce the risk of peritoneal carcinomatosis.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982708","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":"Adjustment to an Appropriate Bedtime Improves Nocturia in Older Adults: A Crossover Study","authors":"Yoshinaga Okumura,&nbsp;Sou Nobukawa,&nbsp;Tomoaki Ishibashi,&nbsp;Tetsuya Takahashi,&nbsp;Masaya Seki,&nbsp;So Inamura,&nbsp;Minekatsu Taga,&nbsp;Masato Fukushima,&nbsp;Hirotaka Kosaka,&nbsp;Osamu Yokoyama,&nbsp;Naoki Terada","doi":"10.1111/iju.70068","DOIUrl":"10.1111/iju.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We examined whether nocturia could be improved by adhering to an appropriate bedtime as determined using a wearable device that measures sleep–wake activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We enrolled patients aged 65 years or older with nocturia at our institution and associated hospital, for whom medical therapy was either not indicated or ineffective. We conducted a prospective crossover comparative study with alternate 4-week intervention and non-intervention periods with a 2-week washout period. During the intervention, participants were instructed to go to bed at a personalized bedtime determined via the steepest descent method, using the data of bedtime and mid-wake time from an Actiwatch Spectrum (Philips Respironics). A frequency volume chart was administered before and after each period. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 24 patients enrolled for the study. The mean age was 79.7 years. The mean bedtime changed from 21:30 to 22:11 after intervention (<i>p</i> &lt; 0.01). During the intervention and non-intervention periods, the mean changes were as follows: nocturnal urinary frequency (−0.90 vs. −0.01 times, <i>p</i> &lt; 0.01), nocturnal urine volume (NUV) (−105.6 vs. +4.4 mL, <i>p</i> = 0.04), hours to undisturbed sleep (HUS) (62.8 vs. 12.7 min, <i>p</i> &lt; 0.01), NUV per hour during HUS (−28.4 vs. −0.17 mL/h, <i>p</i> = 0.04), and PSQI scores (−2.4 vs. 1.2, <i>p</i> = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In older patients with nocturia, going to bed at appropriate times, determined using a wearable device that measures sleep–wake activity, might potentially prolong HUS, decrease NUV, specifically NUV/h during HUS, and consequently improve nocturia and sleep quality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"870-876"},"PeriodicalIF":1.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965965","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 “Active Surveillance in Prostate Cancer With Intermediate-Risk Features: The PRIAS-JAPAN Study”","authors":"Rocio Roldan-Testillano,&nbsp;Rafael Sanchez-Salas","doi":"10.1111/iju.70083","DOIUrl":"10.1111/iju.70083","url":null,"abstract":"<p>The expansion of active surveillance (AS) beyond low-risk prostate cancer (PCa) continues to be a subject of ongoing debate. The PRIAS-JAPAN study by Blas et al. provides valuable prospective data on the medium-term outcomes of AS in Japanese men with intermediate-risk features—specifically ISUP grade group 2 and/or clinical stage T 2—compared to those in low-risk patients enrolled in the same protocol [<span>1</span>].</p><p>Among 1066 patients followed for a median of over 3 years, no statistically significant differences were found between low- and intermediate-risk groups in pathological reclassification rates, AS program persistence, or transition to active treatment. These findings align with recent studies suggesting that carefully selected men with intermediate-risk PCa may safely undergo AS in the short to medium term [<span>2</span>]. However, the short follow-up for the intermediate-risk cohort and its relatively small sample size warrant caution in overgeneralizing these conclusions.</p><p>A particularly noteworthy observation is the difference in treatment patterns post-AS: patients with ISUP grade group 1 were more likely to undergo radical prostatectomy, whereas those with grade group 2 more often received external beam radiotherapy. This likely reflects age-related treatment preferences, as the intermediate-risk cohort was older, partly due to PRIAS-JAPAN's historical age-based eligibility criteria for ISUP 2. These findings underscore the complexity of AS decision-making and the need for individualized patient counseling.</p><p>Despite reassuring similarities in reclassification and persistence rates, key limitations must be considered. The lack of central pathology review, limited clinical stage T2 subgroup stratification, and evolving eligibility criteria over time may have influenced the results. Moreover, while not statistically significant, ISUP grade 2 patients appeared more likely to be reclassified at the second biopsy, suggesting a need for closer monitoring. Longer-term follow-up is essential to assess whether AS remains oncologically safe for intermediate-risk PCa, particularly regarding metastasis-free and cancer-specific survival. Future studies should also explore the role of modern diagnostic tools—such as multiparametric MRI and genomic classifiers—to refine risk stratification and optimize surveillance strategies [<span>3, 4</span>].</p><p>In conclusion, the PRIAS-JAPAN study provides valuable real-world evidence supporting the cautious extension of AS to well-selected intermediate-risk PCa patients. It reinforces the importance of individualized decision-making, considering patient age, comorbidities, and personal preferences, as highlighted in the DETECTIVE Study [<span>5</span>].</p><p>Both authors equally contributed to the conception of the editorial comment, literature review, and writing of the manuscript. Both authors approved the final version.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"828-829"},"PeriodicalIF":1.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009335","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 the COVID-19 Pandemic on Prostate Cancer: Perturbations in Screening and Diagnostic Patterns.","authors":"Takahide Noro, Takanobu Utsumi, Naoki Ishitsuka, Yuta Suzuki, Shota Iijima, Yuka Sugizaki, Takatoshi Somoto, Ryo Oka, Takumi Endo, Naoto Kamiya, Nobuyuki Hiruta, Hiroyoshi Suzuki","doi":"10.1111/iju.70085","DOIUrl":"https://doi.org/10.1111/iju.70085","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of the COVID-19 pandemic on prostate cancer screening, patient characteristics, and clinical outcomes by comparing data before and after the pandemic at a Japanese institution.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Toho University Sakura Medical Center, including 955 patients who underwent prostate biopsy between March 2018 and May 2022. The study period was divided into pre-pandemic (March 2018 to March 2020) and post-pandemic (April 2020 to May 2022) phases. Data on demographic characteristics, referral patterns, clinical presentation, and biopsy results were collected. Statistical analyses were performed to evaluate differences in key clinical parameters before and after the onset of the pandemic.</p><p><strong>Results: </strong>The median age of patients undergoing prostate biopsy increased significantly during the post-pandemic period (71.0 years before vs. 73.0 years after, p < 0.01). Referrals from PSA screening decreased significantly (13.5% before vs. 9.0% after, p = 0.03), whereas referrals from office urologists increased (29.8% before vs. 38.0% after, p < 0.01). The overall detection rate of prostate cancer remained stable (62.0% before vs. 67.0% after, p = 0.10). However, the proportion of higher Gleason grade groups (4 and 5) increased significantly after the pandemic (46.8% before vs. 68.1% after, p < 0.01).</p><p><strong>Conclusions: </strong>The COVID-19 pandemic led to notable changes in prostate cancer screening practices and an increase in higher-grade cancer diagnoses. These findings highlight the importance of maintaining robust cancer screening programs and ensuring timely diagnosis during public health crises to mitigate adverse clinical outcomes.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999784","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":"New Technology in Percutaneous Nephrolithotomy: Application of Navigation System, Robotics, Artificial Intelligence, and Suction Access Sheath","authors":"Kazumi Taguchi,&nbsp;Heiko Yang,&nbsp;David B. Bayne,&nbsp;Rei Unno,&nbsp;Shuzo Hamamoto,&nbsp;Thomas Chi,&nbsp;Takahiro Yasui","doi":"10.1111/iju.70057","DOIUrl":"10.1111/iju.70057","url":null,"abstract":"<p>In the dynamic field of urology, percutaneous nephrolithotomy is the gold standard procedure for treating large kidney stones and has greatly benefitted from technological advancements that improve its safety and efficacy. This review highlights significant innovations in percutaneous nephrolithotomy including integrated navigation systems, robotics, artificial intelligence, and suction access sheaths, each collectively providing greater precision and improved patient outcomes. Three-dimensional navigation systems offer unparalleled anatomical insights, facilitate more accurate targeting, and reduce intraoperative complications, as evidenced by studies demonstrating higher success rates and shorter operation times. Robotic advancements can further refine percutaneous nephrolithotomy by offering superior control and accuracy. Emerging technologies such as the automated needle targeting with X-ray and MONARCH platforms show the potential to reduce radiation exposure and improve procedural efficiency. Additionally, artificial intelligence in percutaneous nephrolithotomy is a novel tool for preoperative planning and outcome prediction, which can enhance decision-making and potentially lead to customized treatment strategies. Suction access sheaths represent another important innovation that facilitates stone removal and reduces the risk of postoperative complications. Integration of these technologies can improve how urologists perform percutaneous nephrolithotomy, and it highlights the benefit of ongoing research and development in the evolving field of kidney stone surgery. Through a comprehensive analysis of peer-reviewed studies, this manuscript delves into the advancements of the last 5 years, underscoring the transformative impact of these innovations on percutaneous nephrolithotomy and setting the stage for future developments in this critical field of urology.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"793-803"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983767","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 to “Impact of Early Detection and Varying Duration of Chemoprophylaxis on Venous Thromboembolism After Robot-Assisted Radical Cystectomy”","authors":"Eiji Kikuchi,&nbsp;Nozomi Hayakawa","doi":"10.1111/iju.70081","DOIUrl":"10.1111/iju.70081","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 7","pages":"848-849"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989731","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}