International Journal of Urology最新文献

{"title":"Surgical and patient-reported outcomes of staged urethroplasty for anterior urethral strictures: A comprehensive analysis.","authors":"Takahiro Minami, Akio Horiguchi, Masayuki Shinchi, Kenichiro Ojima, Yuhei Segawa, Yoshiyuki Furukawa, Kazuki Takekawa, Sadayoshi Suzuki, Hakaru Masumoto, Jumpei Katsuta, Daisuke Watanabe, Keiichi Ito","doi":"10.1111/iju.15679","DOIUrl":"https://doi.org/10.1111/iju.15679","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of staged urethroplasty for complex anterior urethral strictures from both surgical and patient-reported outcome perspectives.</p><p><strong>Methods: </strong>This retrospective study included 100 patients who underwent staged urethroplasty for anterior urethral strictures between May 2011 and June 2023. Anatomical success was defined as the ability to pass cystourethroscopy without resistance and the patient's ability to void without additional interventions. Patient-reported outcomes were evaluated using validated questionnaires, including the urethral stricture surgery patient-reported outcome measure, sexual health inventory for men (SHIM), and EuroQol 5-dimension (EQ-5D), administered pre-and postoperatively.</p><p><strong>Results: </strong>At a median follow-up of 53 months, the anatomical success rate was 89.0%. Seventeen (17.0%) required revision surgery between stages. Perioperative complications occurred in 13 (13.0%). Significant improvements were observed in maximum flow rate (p < 0.0001), postvoid residual volume (p = 0.0006), total lower urinary tract symptoms (LUTS) scores (p < 0.0001), LUTS-specific quality of life (QOL) score (p < 0.0001), EQ-5D index score (p < 0.0001), and EQ-5D visual analog scale score (p < 0.0001). SHIM scores showed no significant change (p = 0.59). Overall, 93.5% of patients reported being either \"satisfied\" or \"very satisfied\" with the outcomes.</p><p><strong>Conclusion: </strong>Staged urethroplasty demonstrates high anatomical success rates and significant improvements in urinary function and QOL without compromising erectile function. The high patient satisfaction rate supports its efficacy in treating complex anterior urethral strictures.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970814","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 “Predictive value of haematologic parameters and HALP score for testicular viability in adults with testicular torsion: A multicentric study”","authors":"Roy Mano MD","doi":"10.1111/iju.15669","DOIUrl":"10.1111/iju.15669","url":null,"abstract":"&lt;p&gt;Testicular torsion is associated with an orchiectomy rate of 39% and a late testicular loss rate of approximately 50% in the pediatric and adolescent population.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Previous studies report a consistent association between symptom duration, degree of torsion, and sonographic features before scrotal exploration and testicular salvage after torsion.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Biomarkers based on the results of a complete blood count are appealing as predictors of outcome since they are readily available and have been previously associated with various inflammatory conditions. However, when evaluating the association between the outcome of scrotal exploration and blood-based biomarkers including immune cell counts, neutrophil-lymphocyte-ratio, platelet-lymphocyte-ratio, and C-reactive protein, findings are inconsistent.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In the current study, Yilmaz et al. evaluated hematological variables, and the hemoglobin, albumin, lymphocyte, and platelet (HALP) score as predictors of testicular viability in adults with testicular torsion.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The HALP score was previously associated with vascular disorders and the vitality of free microvascular flaps and may therefore be a potential biomarker for testicular salvageability. The authors report that patients who underwent orchiectomy had significantly lower HALP scores (43.7 ± 33.9 vs. 56.6 ± 44.3, adjusted &lt;i&gt;p&lt;/i&gt;-value = 0.03), higher platelet to lymphocyte ratio, higher degree of torsion, higher MCV, longer duration of torsion and heterogenous echotexture on sonography. However, multivariable logistic regression analysis revealed that only heterogeneous echotexture (OR = 14.3, 95% CI = 2.4–85.5, &lt;i&gt;p&lt;/i&gt; = 0.004) and duration of torsion (OR = 1.1, 95% CI = 1–1.1, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) were significant predictors for orchiectomy on scrotal exploration; thus, the authors did not find an association between the HALP score and additional hematological markers and the outcome of testicular torsion.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The authors acknowledge the limitations of the study including its retrospective nature, small cohort size, and lack of long-term follow-up. Despite these limitations, preoperative sonographic echotexture and duration of symptoms were found to be predictors of outcome at scrotal exploration consistent with previous studies.&lt;/p&gt;&lt;p&gt;Gross testicular heterogeneity on preoperative ultrasonography was repeatedly associated with testicular loss following torsion. In an attempt to provide an objective measure of sonographic heterogeneity, Samson et al. analyzed ultrasound images of the testes with a computer software and compared the heterogeneity index of the affected and contralateral testis providing an objective variable able to determine the viability of a torsed testis with a sensitivity, specificity, positive predictive value and negative predictive value of 100%, 94.5%, 86%, and 100%, respectively.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"32 3","pages":"307"},"PeriodicalIF":1.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948928","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":"Periapical triangle block for catheter-related bladder discomfort in patients undergoing thulium laser vaporization of the prostate.","authors":"Kuniaki Inoue, Masatake Shinohara, Toshihisa Saka, Yoshihiko Hirao","doi":"10.1111/iju.15677","DOIUrl":"https://doi.org/10.1111/iju.15677","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965103","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":"Predictive ability of lesion localization using real-time three-dimensional magnetic resonance imaging/ultrasound fusion prostate biopsy in robot-assisted laparoscopic prostatectomy.","authors":"Yukari Bando, Jun Teishima, Yoshiko Ueno, Koji Chiba, Hideaki Miyake","doi":"10.1111/iju.15667","DOIUrl":"https://doi.org/10.1111/iju.15667","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948933","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":"Impact of imaging parameters of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography on treatment response to pembrolizumab in patients with metastatic urothelial carcinoma.","authors":"Rikuto Yasujima, Hajime Tanaka, Junichi Tsuchiya, Yuma Waseda, Soichiro Yoshida, Yasuhisa Fujii","doi":"10.1111/iju.15673","DOIUrl":"https://doi.org/10.1111/iju.15673","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948931","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":"Racial disparity in preoperative C-reactive protein level for predicting prognosis of patients with non-metastatic clear cell renal cell carcinoma: INMARC study.","authors":"Wei Chen, Hajime Tanaka, Masaki Kobayashi, Shohei Fukuda, Akinori Nakayama, Margaret F Meagher, Soichiro Yoshida, Ithaar H Derweesh, Viraj A Master, Akihiro Hirakawa, Yasuhisa Fujii, Kazutaka Saito","doi":"10.1111/iju.15671","DOIUrl":"https://doi.org/10.1111/iju.15671","url":null,"abstract":"<p><strong>Background: </strong>C-reactive protein (CRP) is a prognostic biomarker for clear cell renal cell carcinoma (ccRCC). However, there may be potential racial heterogeneity in distribution and prognostic impact of CRP level. We investigated potential racial differences in distribution and prognostic impact of preoperative CRP among Asian (AS), African American (AA), and Caucasian (CAUC) patients with non-metastatic ccRCC (nmccRCC).</p><p><strong>Methods: </strong>We retrospectively analyzed 1991 nmccRCC cases (AS/AA/CAUC: n = 968/223/800) undergoing nephrectomy from the international multi-institutional database. We investigated CRP distributions and optimal cut-off values for predicting recurrence-free survival (RFS) and overall survival (OS) using Cox regressions for each racial group. Subgroup analyses considered comorbidities, pathological T stage, and Fuhrman grade.</p><p><strong>Results: </strong>Preoperative CRP distributions differed significantly among the races, with median values of 0.90 mg/L (interquartile range, 0.40-2.33) for AS, 5.00 mg/L (1.98-12.20) for AA, and 3.55 mg/L (1.41-8.48) for CAUC (p < 0.01). Optimal cut-off values for RFS were 1.2 mg/L in AS, 2.8 mg/L in AA, and 1.7 mg/L in CAUC, showing C-indices of 0.77, 0.71, and 0.77, respectively. For OS, they were 1.6 mg/L in AS, 8.3 mg/L in AA, and 9.3 mg/L in CAUC, yielding C-indices of 0.77, 0.70, and 0.74, respectively. Subgroup analyses revealed varying reference ranges of CRP levels among races (1.1-2.2/2.7-5.0/1.5-3.4 mg/L for RFS, and AS/AA/CAUC: 0.9-3.0/8.0-12.7/8.0-10.4 mg/L for OS, respectively).</p><p><strong>Conclusion: </strong>The preoperative CRP distributions and their optimal cut-off values for predicting patient prognosis differed significantly among the races. Using race-specific cut-off values, CRP demonstrated consistently high-prognostic accuracies, which may improve tailored patient management in nmccRCC.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927122","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":"Bowel regimens before radical cystectomy: An analysis of a modern cohort.","authors":"Rishabh K Simhal, Connor McPartland, Kerith R Wang, Matthew Buck, Yash B Shah, Maria L Poluch, Aaron R Hochberg, Brian H Im, Thenappan Chandrasekar, Mihir S Shah, Costas D Lallas","doi":"10.1111/iju.15668","DOIUrl":"https://doi.org/10.1111/iju.15668","url":null,"abstract":"<p><strong>Introduction: </strong>Bowel regimens (BR) before radical cystectomy (RC) are currently not recommended by Enhanced Recovery After Surgery (ERAS) protocols, as prior studies have shown BRs lead to worsened outcomes. However, many of those studies have used historic literature before recent surgical advancements such as minimally invasive RC and have not investigated the impact BRs have by type of urinary diversion. Our goal is to determine the outcomes of preoperative BR in patients undergoing RC based on diversion type using a modern patient cohort.</p><p><strong>Methods: </strong>RCs performed between 2019 and 2020 with BR information available were identified in the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). Patients were grouped by type of BR received: no BR, both mechanical bowel preparation (MBP) and preoperative oral antibiotic BR (OABR), MBP only, and OABR only. We conducted propensity score matching based on factors influencing the operative approach. Baseline demographics and 30-day complication rates were compared between matched groups. We analyzed hospital length of stay (LOS) via multivariate regression with a Poisson distribution.</p><p><strong>Results: </strong>In total, 2054 RCs were identified with 2.4% receiving OABR, 21.3% receiving MBP, 5.3% receiving both, and 71.0% receiving no BR. For patients with ileal conduit diversions, outcomes with BRs appeared mixed, as OABR leads to increased LOS. For patients with neobladder diversions, BRs were not associated with any worsened outcomes and were associated with reduced length of stay.</p><p><strong>Conclusions: </strong>BRs such as OABR may associated with improved outcomes in patients receiving RC with neobladder diversion, a finding that warrants further investigation.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927119","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":"Impact of surgical volume on outcomes of laparoscopic adrenalectomy for benign adrenal tumors: A Japanese nationwide database analysis.","authors":"Yuma Waseda, Wei Chen, Minato Yokoyama, Shohei Fukuda, Hajime Tanaka, Soichiro Yoshida, Masumi Ai, Akihiro Hirakawa, Kiyohide Fushimi, Yasuhisa Fujii","doi":"10.1111/iju.15670","DOIUrl":"https://doi.org/10.1111/iju.15670","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the recent status of laparoscopic adrenalectomy for benign adrenal tumors, focusing on the relationship between the number of surgeries and complication rates per facility.</p><p><strong>Methods: </strong>Data were obtained from the Diagnosis Procedure Combination database, covering surgeries performed between April 2012 and March 2020. The inclusion criteria were laparoscopic adrenalectomy for benign adrenal tumors. Basic characteristics and outcomes, including anesthesia time, blood transfusion, and medical costs, were analyzed. The facilities were divided into five categories in increments of five adrenalectomies per year. The relationship between the number of surgeries per facility and complication rates was analyzed using the Cochran-Armitage trend test and chi-square tests with the Holm method applied for multiple comparisons.</p><p><strong>Results: </strong>A total of 15 174 laparoscopic adrenalectomies for benign adrenal tumors were performed across 543 facilities during the 9-year study period. The number of adrenalectomies performed annually was <5, 5-9, 10-14, 15-19, ≥20 in 434 (79.9%), 58 (10.7%), 28 (5.2%), 12 (2.2%), and 11 (2.0%) facilities, respectively, showing that only 51 facilities (9.4%) conducted 10 or more surgeries per year. The overall complication rate was 9.1%. A trend was demonstrated showing that facilities with a higher number of surgeries per year had reduced complication rates. Facilities with 20 or more surgeries per year had the shortest anesthesia times and the lowest medical costs. No significant differences were found in blood transfusion rates or in-hospital mortality.</p><p><strong>Conclusion: </strong>Laparoscopic adrenalectomy for benign adrenal tumors can be performed at lower complication rates in facilities with a higher number of surgeries.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927120","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 correlation between discrepancies in clinical and pathological T stages and overall survival in upper urinary tract urothelial carcinoma: Analysis of the hospital-based cancer registry data in Japan.","authors":"Masanobu Shiga, Yoshiyuki Nagumo, Kosuke Kojo, Shuya Kandori, Reo Takahashi, Bunpei Isoda, Shuhei Suzuki, Kazuki Hamada, Kozaburo Tanuma, Satoshi Nitta, Akio Hoshi, Hiromitsu Negoro, Bryan J Mathis, Ayako Okuyama, Hiroyuki Nishiyama","doi":"10.1111/iju.15665","DOIUrl":"https://doi.org/10.1111/iju.15665","url":null,"abstract":"<p><strong>Objective: </strong>Our study assessed the correlation between discrepancies in clinical and pathological T stages and overall survival (OS) in patients with upper urinary tract urothelial carcinoma (UTUC), including renal pelvis (UCP) and ureter (UCU) carcinoma, treated with radical surgery.</p><p><strong>Methods: </strong>We utilized data from the Japanese Hospital-Based Cancer Registry (HBCR) to identify UTUC cases (n = 2376), consisting of UCP cases (n = 1196) and UCU cases (n = 1180), diagnosed with cTa-3N0M0 between 2012 and 2013. All cases were histologically confirmed and treated solely with radical surgery, excluding any chemotherapy or radiotherapy. We investigated the correlation between stage classification discrepancies and OS.</p><p><strong>Results: </strong>Among UCP and UCU patients, cT2N0M0 had the highest discrepancy rates between clinical and pathological stages (68% and 51%), while cT3N0M0 had the lowest (21% and 20%). Among UCP and UCU patients with cTa/is/1N0M0, those with up-staging showed significantly worse OS compared to same-staging (HR 1.7 and 2.5, p = 0.001 and <0.001, respectively). In UCU patients with cT2N0M0, the 5-year OS rates were 41.9% for up-staging, 63.7% for same-staging, and 76.4% for down-staging, with significantly worse survival in the up-staged group. Among UCP and UCU patients with cT3N0M0, the 5-year OS rates were 29.3% and 7.7% for those with up-staging, 53.7% and 30.6% for those with same staging, and 79.6% and 65.4% for those with down-staging.</p><p><strong>Conclusion: </strong>Using a large real-world cohort, we found stage discrepancies to be a significant independent prognostic factor in non-metastatic UTUC patients. Treatment should be carefully selected, considering T-staging discrepancies and prognosis.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921760","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":"α₁-Blockers as a risk factor for hypotension in combination with oral 5-aminolevulimic acid for photodynamic diagnosis in patients with bladder cancer.","authors":"Chihiro Suzuki, Tomonori Minagawa, Hiromu Onuma, Shiro Hiragata, Yoshiaki Kinebuchi","doi":"10.1111/iju.15655","DOIUrl":"https://doi.org/10.1111/iju.15655","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921761","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}