International Urology and Nephrology最新文献

{"title":"Unsupervised clustering analysis of treatment strategies for elite female athletes with severe stress urinary incontinence: focusing on competition return and SUI improvement.","authors":"Nobuo Okui, Machiko Okui","doi":"10.1007/s11255-024-04337-6","DOIUrl":"https://doi.org/10.1007/s11255-024-04337-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate two primary outcomes in elite female athletes (EFAs) with severe stress urinary incontinence (SUI) 24 months post-intervention: return to elite-level competition and improvement in SUI symptoms. Clustering analysis was conducted to identify subgroups within the patient population and explore treatment efficacy.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 183 EFAs with severe SUI who underwent treatments including pelvic floor muscle training (PFMT), vaginal and urethral erbium laser (Fotona Laser), and mid-urethral sling (MUS) surgery. Clustering analysis was conducted using K-means to categorize patients, followed by multivariate regression and Random Forest to determine predictors.</p><p><strong>Results: </strong>Three distinct clusters were identified. PFMT frequency was the most significant predictor of both return to sports and SUI improvement across clusters. Cluster 0, characterized by younger participants, required interventions like MUS surgery and Fotona Laser for significant improvement. Cluster 2, with high PFMT adherence, showed the best improvement in pad test results (4.9 g) and the highest return to sports rate (85.9%). Fotona Laser was particularly effective in Cluster 2, with 91.3% of patients returning to sports within one year. In contrast, Cluster 1, which included older participants with more severe symptoms, demonstrated the least improvement and lowest return to sports rate (2.8%), likely due to lower PFMT frequency and inconsistent training.</p><p><strong>Conclusion: </strong>Clustering analysis effectively categorized EFAs with SUI, highlighting the critical role of personalized, intensive PFMT in achieving sports return and symptom improvement. Future research should validate findings in larger cohorts and integrate machine learning to refine personalized medicine.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing patient satisfaction with hemodialysis and peritoneal dialysis care and associated factors in Iran.","authors":"Nastaran Nemati, Mahmood Yousefi, Fatemeh Keshvari-Shad, Soleiman Akbari, Eshagh Barfar","doi":"10.1007/s11255-024-04346-5","DOIUrl":"https://doi.org/10.1007/s11255-024-04346-5","url":null,"abstract":"<p><strong>Purpose: </strong>With the increasing demand for dialysis, there is a growing emphasis on patient-centered care. This study investigated patients' satisfaction levels with peritoneal dialysis (PD) and hemodialysis (HD) care in Iran.</p><p><strong>Methods: </strong>A cross-sectional multicenter study was conducted among 346 patients with chronic kidney disease (CKD) covered by the Iran Health Insurance Organization who received dialysis services from October to December 2022 across the country. Data were gathered using a self-made questionnaire through telephone interviews. Data analysis included descriptive statistics, t tests, ANOVA, and linear logistic regression using R software.</p><p><strong>Results: </strong>Patients reported high satisfaction with doctors and nurses, health care facilities, and costs. PD patients had higher overall satisfaction (P < 0.001) and were more satisfied with costs (P < 0.001), while HD patients reported greater satisfaction with doctor and nurse behavior (P = 0.012). Significant factors associated with satisfaction included marital status (P = 0.012), insurance coverage duration (P = 0.027), dialysis type (P < 0.001), and time to dialysis initiation (P = 0.027). Doctor and nurse behavior had the greatest impact on satisfaction (P < 0.001).</p><p><strong>Conclusion: </strong>While patients were generally satisfied with the care provided, the findings revealed areas for improvement, particularly regarding the availability of medical centers and costs among dialysis patients. Focusing on patient education, communication, and supportive insurance policies has the potential to significantly enhance patient satisfaction and improve quality of life for dialysis patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical malpractice related to urology: an analysis of court decisions in Turkey.","authors":"Umit Uysal, Murat Ucar","doi":"10.1007/s11255-024-04354-5","DOIUrl":"https://doi.org/10.1007/s11255-024-04354-5","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to examine the lawsuits filed against urologists in Turkey, to reveal the results of these lawsuits and the sub-branch of urology they are related to, to discuss the possible reasons for the lawsuits and what can be done to prevent them.</p><p><strong>Materials and methods: </strong>The case outcomes obtained using the keyword \"Urology\" from the publicly accessible official website of the Presidency of the Supreme Court of the Republic of Turkey between 2018 and 2024 were analyzed by two expert urologists.</p><p><strong>Results: </strong>Of the 215 cases reviewed, the outcomes of 25 cases that met our inclusion criteria were analyzed. Sixteen of these cases were filed against private hospitals. Fourteen of the Supreme Court rulings involved civil (compensation) lawsuits, while 11 were criminal cases. Thirteen cases were related to endourology, and 9 patients had urinary system stone disease. Seventeen of the lawsuits involved allegations of postoperative medical errors. Five cases were attributed to procedural skill errors, and four were due to a lack of informed consent. Complications led to the death of seven patients. The decisions of the first-instance courts resulted in 12 acquittals, 7 compensation rulings, and 6 criminal convictions. At the Supreme Court level, 12 cases were ruled against the physicians.</p><p><strong>Conclusions: </strong>Nearly half of the cases resulted in rulings against urologists, with the majority being related to endourology. Our study emphasizes the importance of adhering to international medical guidelines, providing informed consent to patients, and carefully conducting postoperative follow-ups.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TITAL: targeting renal fibrosis with sulforaphane-a promising therapeutic strategy.","authors":"Hussain Ramzan, Humaira Kousar, Azeem Rab Nawaz","doi":"10.1007/s11255-024-04352-7","DOIUrl":"https://doi.org/10.1007/s11255-024-04352-7","url":null,"abstract":"<p><p>Renal fibrosis is a hallmark of chronic kidney disease, characterized by the excessive accumulation of extracellular matrix proteins. Sulforaphane, a potent antioxidant found in cruciferous vegetables, has shown promise in targeting renal fibrosis. By inhibiting fibrotic pathways, such as TGF-β signaling, and promoting antioxidant defenses, sulforaphane may offer a novel therapeutic strategy for mitigating kidney damage and slowing disease progression. Further research is needed to fully explore its therapeutic potential.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stone-event-free survival after retrograde intrarenal surgery: is the stone-free-status so relevant for the future outcomes?","authors":"Sofia Mesquita, Gonçalo Mendes, Miguel Marques-Monteiro, Maria Alexandra Rocha, Mariana Madanelo, Avelino Fraga, Vítor Cavadas","doi":"10.1007/s11255-024-04343-8","DOIUrl":"https://doi.org/10.1007/s11255-024-04343-8","url":null,"abstract":"<p><strong>Introduction: </strong>The primary aim of stone treatment is to achieve stone-free status. Residual fragments can cause stone growth, recurrence, urinary tract infections, and ureteric obstruction. Our goal was to describe the natural history of stone burden after retrograde intrarenal surgery (RIRS) based on stone-free status (SFS), evaluating stone growth and stone-events.</p><p><strong>Methods: </strong>We retrospectively reviewed data from patients who underwent RIRS at a tertiary care center between October 2014 and September 2019. The stone burden was assessed by measuring the maximum diameter (mm) and volume (mm³). Patients were divided into four groups according to SFS-(A) absolute stone-free, no stones on non-contrast-enhanced computed tomography (NCCT); (B) relative stone-free with ≤ 2 mm fragments, (C) relative stone-free with 2.1-4 mm fragments, and (D) residual fragments > 4 mm. Our main outcomes were stone growth over time (defined as an increase in diameter compared to first postoperative measurement) and incidence of stone-related events (pain or additional intervention to treat symptoms, obstruction, or removing fragments).</p><p><strong>Results: </strong>A total of 98 patients were included in the study-42 were classified as absolute stone-free (Group A), 20 were categorized as relatively stone-free (Groups B and C), and 36 had a residual stone burden with fragments larger than 4 mm (Group D) on postoperative NCCT. There was a significant difference in the number of stones among the groups (p < 0.001). The pre-operative stone volume differed significantly among the groups (p = 0.003). Group A had the lowest median total stone volume (551.3 mm³). Twenty patients (20.4%) developed stone-events during a mean follow-up period of 62.3 months (± 26.0). Stone-event-free survival differed significantly between the groups (p = 0.028), with Group D demonstrating a higher incidence of stone-related events post-RIRS compared to the other groups. Sixteen patients (16.3%) had renal colic requiring a hospital visit across all groups. Thirteen patients (13.3%) required re-intervention (3 patients belonged to Group A, 1 to Group B, 2 to Group C, and 7 to Group D).</p><p><strong>Conclusions: </strong>Group D shows a higher rate of stone-related events post-RIRS. Ensuring complete stone-free status after RIRS is crucial for treatment success. Other factors should be considered in the management, including ensuring compliance with general preventive measures and stone-specific pharmacological treatments to prevent recurrence.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological features and treatment outcomes of urothelial carcinoma variant histologies and non-urothelial bladder cancers.","authors":"İsmet Seven, Selin Aktürk Esen, Serhat Sekmek, İrfan Karahan, Müge Büyükaksoy, Tuba Dilay Kökenek Ünal, Doğan Uncu","doi":"10.1007/s11255-024-04341-w","DOIUrl":"https://doi.org/10.1007/s11255-024-04341-w","url":null,"abstract":"<p><strong>Purpose: </strong>Most bladder cancers are pure urothelial carcinomas, but a small portion, approximately 5-10%, have variant histology or are non-urothelial in nature. This research sought to examine the features of and treatment strategies for different types of urothelial carcinoma with variant histologies and non-urothelial bladder cancer.</p><p><strong>Methods: </strong>The study cohort comprised individuals with non-urothelial and variant urothelial bladder cancers treated at two medical centres in Ankara, Turkey, between 2005 and 2024.</p><p><strong>Results: </strong>A total of 104 individuals were reviewed, with 88 having urothelial cancer with variant histology and 16 having non-urothelial cancer. Non-urothelial cancers included neuroendocrine, undifferentiated, adenocarcinoma, squamous, sarcoma, and carcinosarcoma, with a median overall survival (OS) of 8 months. The most frequent urothelial carcinoma variants were squamous (43 cases), plasmacytoid (9 cases), and sarcomatoid (6 cases). Individuals with operable variants of urothelial malignancies had a median disease-free survival (DFS) of 16.5 months, while individuals with inoperable/metastatic variants experienced a median progression-free survival (PFS) of 8.9 months. The median OS in the operable cohort was 18.5 months, compared to 10.8 months in the inoperable/metastatic group.</p><p><strong>Conclusion: </strong>The present study reveals that variant urothelial and non-urothelial bladder cancers are aggressive in nature and have poor prognosis. Given the significant heterogeneity observed in OS, DFS, and PFS among these rare and diverse tumor subtypes, large-scale multicenter investigations are required to establish a consensus on patient handling and treatment.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile app communication to prevent ER visits post-circumcision: a prospective observational study.","authors":"Adem Sancı, İsmail Emre Ergin, Abuzer Öztürk, Aydemir Asdemir","doi":"10.1007/s11255-024-04345-6","DOIUrl":"https://doi.org/10.1007/s11255-024-04345-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of a mobile phone application facilitating real-time visual and verbal communication on reducing emergency-room admissions following circumcision.</p><p><strong>Methods: </strong>This prospective observational study included circumcision surgeries performed by one surgeon at our clinic between April and June 2024, after obtaining parental consent. Parents were divided into two groups: one received a mobile app phone number, while the other did not. The mobile app group was based on parents' communication needs, such as distance or socioeconomic factors. Follow-up appointments were scheduled for one week and one month; the mobile app group had follow-ups via the app, while the non-communicating group followed up in person. WhatsApp was used due to its cost-effectiveness and accessibility. Data on emergency visits, communications, and complications were recorded prospectively and analyzed retrospectively using SPSS with t tests and Mann-Whitney U tests (p < 0.05).</p><p><strong>Results: </strong>A total of 200 patients were enrolled, with 162 meeting the inclusion criteria. The study was divided into two groups: 'Communicating group' (Group 1, 75 patients) had access to the mobile app, while 'Non-communicating group' (Group 2, 87 patients) received routine post-operative instructions. No significant differences in age or weight were found. The most common complications included wound infection, non-healing wounds, swelling, bleeding, and micturition issues. Emergency visits were significantly higher in Group 2 (12.64%) compared to Group 1 (1.33%) (p = 0.01).</p><p><strong>Conclusion: </strong>The use of a mobile app for post-surgical communication may significantly reduce emergency-room visits following circumcision.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between the course of kidney injury and clinicopathology and prognosis of children with Henoch-Schönlein purpura nephritis.","authors":"Yuying Sun, Xiaoqing Yang, Leying Xi, Zhiyuan Feng, Xianqing Ren","doi":"10.1007/s11255-024-04336-7","DOIUrl":"https://doi.org/10.1007/s11255-024-04336-7","url":null,"abstract":"<p><strong>Purpose: </strong>Henoch-Schönlein purpura nephritis (HSPN) has a poor prognosis and variable pathophysiology. The present study aimed to analyze the kidney injury, clinicopathology, and prognosis of HSPN children.</p><p><strong>Methods: </strong>This retrospective study examined 249 children with HSPN. The patients' pathological and clinical data were collected. The patients were divided into the following groups according to the duration of their kidney injury: groups with disease duration of < 2 weeks, 2 weeks to 1 month, 1-2 months, 2-4 months, 4-6 months, and ≥ 6 months. The clinicopathological and prognostic relationships were examined between the groups.</p><p><strong>Results: </strong>We enrolled 249 children with HSPN (average age of 10.12 ± 3.01 years). There were 161 boys (64.66%) and 88 girls (35.34%). Altogether, 191 children (76.71%) developed kidney injury within 2 months. A total of 37 children (14.86%) showed recurrent renal damage after 6 months. Most patient groups exhibited hematuria and proteinuria, with type III pathology being the most common. During 2 weeks and 1 month of kidney injury, the acute pathology index peaked and then decreased; then, it increased again after 4 months as recurrence occurred. The chronic pathology index was the highest in the group with a disease duration of 2-4 months and it increased with increasing disease duration. The prognosis worsens with the disease duration.</p><p><strong>Conclusion: </strong>Children with HSPN showed disease remission after a duration of 4-6 months. The acute and chronic pathology indexes peaked between 2 weeks to 1 month and 2-4 months, respectively. Patients with kidney injury occurring within a month had a much higher remission rate.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effects of tadalafil and N-acetyl cysteine therapy on cisplatin-induced testicular toxicity.","authors":"Alihan Kokurcan, Fatih Sandıkçı, Muhammet Şahin Yılmaz, Ufuk Öztürk, Kutsal Doğan, Demet Yılmazer, Fevzi Nuri Aydın, Ali Yalçındağ, Abdurrahim İmamoğlu","doi":"10.1007/s11255-024-04338-5","DOIUrl":"https://doi.org/10.1007/s11255-024-04338-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether tadalafil (TAD) and N-acetyl cysteine (NAC) can prevent cisplatin (CIS)-induced testicular toxicity.</p><p><strong>Methods: </strong>Forty Wistar-Albino rats were divided into five groups: Control group, CIS group, TAD group, NAC group and TAD + NAC group. All groups were compared regarding body and testicular weights, testicular volumes, blood testosterone levels, testicular tissue malondialdehyde (MDA) levels, histopathological features, and testicular Cosentino and Johnsen scores.</p><p><strong>Results: </strong>There was no significant difference between the groups regarding body weights and Johnsen scores. It was observed that TAD and NAC affected the apoptotic index, and Cosentino scores were lower in these groups than in the control group. This effect was most prominent in the TAD + NAC group. The CIS treatment led to a decrease in serum testosterone levels. While testosterone levels were higher in the TAD Group, no statistically significant difference was found between the groups. Combination therapy and NAC did not affect blood testosterone levels.</p><p><strong>Conclusions: </strong>Cisplatin has adverse effects on the testicular tissue. The histopathological changes caused by this agent can be prevented by TAD + NAC combination therapy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of extended immunotherapy in advanced clear cell renal cell carcinoma treated with first-line combination of immune-checkpoint inhibitor and tyrosine kinase inhibitor.","authors":"Qian Wang, Xingming Zhang, Qiyu Zhu, Hong Zeng, Jindong Dai, Junru Chen, Jinge Zhao, Guangxi Sun, Zhenhua Liu, Hao Zeng, Pengfei Shen","doi":"10.1007/s11255-024-04344-7","DOIUrl":"https://doi.org/10.1007/s11255-024-04344-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of extended immunotherapy in first-line immune checkpoint inhibitors (ICIs)-tyrosine kinase inhibitors (TKIs) combination treatment for advanced renal cell carcinoma (RCC).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed data from patients with advanced RCC who received first-line ICIs-TKIs combination treatment at West China Hospital of Sichuan University between October 2018 and July 2024. Patients who are assessed as having a disease control status after 2 years of continuous treatment will continue to receive immune checkpoint inhibitors until the inhibitors are discontinued due to disease progression or death.</p><p><strong>Result: </strong>A total of 86 patients were screened and 14 patients diagnosed with clear cell RCC (ccRCC) were enrolled. After 65 months of follow-up, three-year progression-free survival (PFS) rate was 71.4% and 4 year PFS rate was 59.5%. The 5 year overall survival (OS) rate was 58.3%. During extended treatment, one patient (7.1%) experienced a transition from stable disease (SD) to partial response (PR) and two patients (14.3%) experienced a transition from PR to complete response (CR). The best tumor shrinkage rates presenting after 24 months had longer PFS and OS compared to those presenting within 24 months (median PFS: not reached vs. 36 months; Hazard Ratio (HR) = 0.10, 95% CI 0.01-0.80, P = 0.03). For safety, extended immunotherapy did not increase treatment-related toxicities compared to safety profile before 24 months.</p><p><strong>Conclusion: </strong>Our analysis of real-world data indicates that patients with extended immunotherapy after 24 months had potential survival benefits and manageable toxicity. Large-scale, prospective studies are still needed to further verify the conclusion.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}