International Urology and Nephrology最新文献

{"title":"Intravesical gemcitabine versus anthracyclines for primary and first recurrent non-muscle-invasive bladder cancer: a single-center retrospective study over 10 years.","authors":"Haobo Fan, Weiwu Chen, Wenhao Guo, Jiayu Han, Haoze Xie, Yanlan Yu, Guoqing Ding, Yicheng Chen","doi":"10.1007/s11255-025-04413-5","DOIUrl":"10.1007/s11255-025-04413-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare intravesical instillation of gemcitabine and anthracyclines in the treatment of primary non-muscle-invasive bladder cancer (NMIBC), and to evaluate the effect of changing intravesical chemotherapy drugs on the the second recurrence of NMIBC.</p><p><strong>Method: </strong>Patients with NMIBC who underwent transurethral resection of bladder tumor (TURBT) for the first time in our center from January 2014 to December 2023 were enrolled. Kaplan-Meier method was used to analyze the recurrence-free survival (RFS) and progression-free survival (PFS), and COX regression was used to analyze the risk factors for recurrence.</p><p><strong>Result: </strong>464 patients were included in the study (212 in the gemcitabine group and 252 in the anthracyclines group). Anthracyclines-treated patients had superior RFS compared to gemcitabine-treated patients (p = 0.006), but PFS did not differ significantly between the two groups (p = 0.654). After the first recurrence of NMIBC, patients who changed intravesical chemotherapy drugs had better RFS than those who kept the original chemotherapy drugs (p = 0.037). In terms of safety, the incidence of adverse events of pirarubicin was significantly higher than that of gemcitabine and epirubicin (55.2% vs 26.4% vs 36.2%, p < 0.001).</p><p><strong>Conclusion: </strong>Anthracyclines are more effective than gemcitabine in preventing recurrence of primary NMIBC but with more adverse events. After the first recurrence of NMIBC, changing the drugs of intravesical chemotherapy can reduce the second recurrence of NMIBC.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2463-2473"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467949","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":"Clinical predictors of bladder outlet obstruction in men consulting for routine urological screening.","authors":"Massimiliano Raffo, Paolo Capogrosso, Edoardo Pozzi, Federico Belladelli, Christian Corsini, Alessandro Bertini, Fausto Negri, Luigi Candela, Alessandro Larcher, Rayan Matloob, Alessia d'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.1007/s11255-025-04432-2","DOIUrl":"10.1007/s11255-025-04432-2","url":null,"abstract":"<p><strong>Purpose: </strong>Lower urinary tract symptoms (LUTS) associated with bladder outlet obstruction (BOO) are prevalent among men, notwithstanding being self-underreported. We aimed to assess the predictors for BOO during first visit.</p><p><strong>Methods: </strong>Data from 1045 analyzed men older than 40 years attending a single urological institution from 2010 to 2021. The men diagnosed with BOO, prostate cancer or any treatment for BOO were excluded. The patients completed the International Prostatic Symptoms Score (IPSS) and were investigated with prostate-specific antigen (PSA), trans-rectal ultrasound to measure prostate volume (PV) and free uroflowmetry. Logistic regression analysis tested the association between parameters and BOO. The area under the curve compared the diagnostic accuracy of predictors. The Youden-index analysis defined the cut-off predicting LUTS.</p><p><strong>Results: </strong>Of 1045 patients, the median (IQR) age was 62 (51-69) years. A total of 773 (74%) had moderate LUTS. Both PV (OR: 1.16; 95%CI 1.04-1.3; p = 0.005) and IPSS (OR: 1.06; 95%CI 1.03-1.08; p < 0.001) were associated with BOO after adjusting for age. They showed a predictive accuracy with an AUC of 0.69 (0.60-0.77) and 0.63 (0.59-0.67) for PV and IPSS, respectively. A PV of 43 mL emerged as the cut-off point to define the risk of BOO. Therefore, a 60-year man with a PV ≥ 43 mL showed an 84% (70-90) risk of BOO as compared with 59% (50-68) for a same age man with lower PV.</p><p><strong>Conclusion: </strong>Men older than 40 years should be screened for LUTS associated with BOO since they are highly prevalent. User-friendly parameters such as PV and IPSS could guide further investigation of BOO.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2513-2518"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565950","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":"Estimated glucose processing rates and the association of chronic kidney disease and proteinuria in non-diabetic adults.","authors":"Hao Zhou, Xuanwen Ru, Simiao Chen, Qing Ye","doi":"10.1007/s11255-025-04448-8","DOIUrl":"10.1007/s11255-025-04448-8","url":null,"abstract":"<p><p>The study, which was based on NHANES data (1999-2018), included 21,234 nondiabetic individuals aged 20 years and older to investigate the associations between the estimated glucose disposal rate (eGDR) and the risk of chronic kidney disease (CKD) and proteinuria. CKD was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m², and proteinuria was defined as a urinary albumin-to-creatinine ratio (UACR) exceeding 30 mg/g. The results demonstrated a significant inverse association between eGDR levels and the risks of CKD and proteinuria. After adjusting for potential confounders, the association between eGDR and CKD showed that, compared with those for Q1, the adjusted odds ratios (ORs) for Q2, Q3, and Q4 were 0.82 (95% CI: 0.61-1.11), 0.62 (95% CI: 0.39-0.98), and 0.55 (95% CI: 0.28-1.05), respectively. For the relationship between eGDR and proteinuria, the adjusted ORs for Q2, Q3, and Q4 were 0.54 (95% CI: 0.42-0.69), 0.41 (95% CI: 0.27-0.62), and 0.65 (95% CI: 0.43-0.98), respectively. Moreover, each standard deviation increase in eGDR was associated with a 9% reduction in CKD risk (OR: 0.91, 95% CI: 0.85-0.98) and a 13% reduction in proteinuria risk (OR: 0.87, 95% CI: 0.82-0.93). Further adjustments via restricted cubic spline (RCS) regression analysis revealed a significant nonlinear relationship between eGDR and CKD and a U-shaped relationship between eGDR and proteinuria. A lower risk of proteinuria was observed when eGDR levels were between 8.70 and 9.91. These findings, combined with those of previous studies, suggest that eGDR may serve as a potential alternative metric for insulin resistance (IR). In nondiabetic individuals, the eGDR was significantly associated with the risk of CKD and proteinuria, with a notable nonlinear pattern in these relationships.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2625-2635"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634033","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":"Observation of the efficacy and safety of obinutuzumab in the treatment of refractory idiopathic membranous nephropathy.","authors":"Luyao Li, Sha Wang, Mingming Wei, Qi Zhang, Lin Fang, Xin Fan, Miaomiao Cheng, Chengrui Zhang, Hua Liang, Xiaoyan Xiao, Xiangdong Yang","doi":"10.1007/s11255-025-04407-3","DOIUrl":"10.1007/s11255-025-04407-3","url":null,"abstract":"<p><strong>Background: </strong>This study analyzed the clinical data of 25 patients with refractory idiopathic membranous nephropathy (RIMN) treated with obinutuzumab, aiming to investigate its efficacy and safety.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with RIMN who were treated with obinutuzumab, admitted to the Department of Nephrology at Qilu Hospital of Shandong University and the Affiliated Hospital of Jining Medical College from March 2022 to November 2023. The treatment of obinutuzumab was determined based on the individual patient's specific circumstances. We collected clinical data including urinary protein-to-creatinine ratio (UPCR), serum albumin, creatinine, estimated glomerular filtration rate (eGFR) and circulating anti-phospholipase 2 receptor (PLA2R) antibodies for a minimum of 12 months. The clinical efficacy and safety of obinutuzumab were evaluated in these patients.</p><p><strong>Results: </strong>Among the 25 patients, 19 (76.0%, responders) achieved partial (n = 16) or complete (n = 3) response with obinutuzumab treatment. The median time to achieve partial response was 3.5 months [interquartile range (IQR) 3.0-12.0 months], and 6 patients were unresponsive to the treatment. After treatment with obinutuzumab, 19 of the 21 patients (90.5%) with positive phospholipase 2 receptor (PLA2R) antibodies achieved complete immunological remission (anti-PLA2R antibodies level < 2 RU/mL). The median time to negativity was 6.0 months (IQR 3.0-9.0 months). The two patients who remained positive had PLA2R antibodies titers that decreased below 14 RU/mL and both achieved clinical remission. The renal function remained stable during the follow-up period. No relapse was observed. No severe adverse events related to obinutuzumab were observed.</p><p><strong>Conclusion: </strong>Obinutuzumab could effectively relieve proteinuria, stabilize renal function and maintain good safety in patients with RIMN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2603-2611"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536823","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":"Assessment of quality of life in patients undergoing hyperthermic intravesical chemotherapy (HIVEC) using EORTC questionnaires (QLQ-C30 and QLQ-NMIBC24).","authors":"Vincenzo Iossa, Antonio Olivieri, Roberto Buonopane, Antonio Di Girolamo, Felice Fiore, Gaetano Sessa, Raffaele Vitale, Ugo Maggio, Alessandro Pontel, Angelo Ferraro, Vittorio Imperatore","doi":"10.1007/s11255-025-04418-0","DOIUrl":"10.1007/s11255-025-04418-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess changes in quality of life (QoL) experienced by patients undergoing hyperthermic intravesical chemotherapy (HIVEC), using validated EORTC QLQ-C30 and EORTC QLQ-NMIBC24 questionnaires.</p><p><strong>Methods: </strong>Between 2021 and 2024, 67 patients with high-risk non-muscle-invasive bladder cancer (NMIBC) who experienced BCG failure or intolerance were enrolled in an HIVEC regimen at our institution. Functional outcomes were evaluated through the EORTC QLQ-C30 and EORTC QLQ-NMIBC24 questionnaires administered at baseline (prior to treatment), after six weekly instillations (induction phase), after three monthly instillations (3 months), and after an additional six monthly instillations (9 months). Each response was assigned a specific score to assess QoL variations over time.</p><p><strong>Results: </strong>Of the 67 patients enrolled, 13 discontinued the therapy. After 9 months, 54 patients completed the EORTC QLQ-C30 and NMIBC24 questionnaires. The QLQ-C30 results indicate that the therapy did not significantly affect daily activities, despite reported increases in fatigue and weakness. However, negative impacts were observed in terms of pain, concentration, and engagement in recreational activities, alongside growing concerns about disease recurrence. The NMIBC24 questionnaire revealed an increase in urinary frequency, associated insomnia, and discomfort related to catheter use. Additionally, there was a decline in libido and anxiety about contaminating their partners.</p><p><strong>Conclusions: </strong>While the initial phase of HIVEC therapy significantly impacts QoL, particularly regarding pain and psychological concerns, it does not drastically affect daily activities in the long term. Nevertheless, the treatment has a negative influence on both physical and mental well-being, contributing to increased anxiety and limitations in social and recreational activities, as well as reduced sexual function.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2415-2423"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441001","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":"Economic evaluation of surgical treatments for urolithiasis in a public hospital.","authors":"Juan F Sánchez Garcia, Adrian Freire Rodríguez, Marco Vinicio Benavides Pineda, Marta Castro Jul, Maximo Castro Iglesias, Jorge Sánchez Ramos, Miguel Pérez Shoch, Sabela López García, Carlos Muller-Artega, María Fernanda Lorenzo Gómez","doi":"10.1007/s11255-025-04422-4","DOIUrl":"10.1007/s11255-025-04422-4","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the costs associated with the surgical treatment of urolithiasis using percutaneous nephrolithotomy (PCNL) and ureterorenoscopy (URS), and to analyze the influence of direct and indirect costs on patient economy and the healthcare system.</p><p><strong>Materials and methods: </strong>A total of 179 patients who underwent surgery for urolithiasis between January 1 and December 31, 2023, were included. Direct costs were recorded, encompassing expenses related to the surgical procedure, hospital stay, and healthcare costs, which included consultations, diagnostic procedures and non-hospital medications. Indirect costs were evaluated as non-healthcare costs, specifically focusing on productivity loss due to absenteeism in employed patients. Average costs per patient were calculated in euros (€).</p><p><strong>Results: </strong>The study found no statistically significant differences in the median total direct costs between patients undergoing PCNL: €15,976 [€13,135-€21,698] and URS: €14,044 [€9,691-€17,696]; p = 0.148). Similarly, the median indirect costs were comparable: €7,800 [€2,323-€7,800] for PCNL and €5,390 [€2,254-€11,136] for URS (p = 0.514). After the interventions, the median time off work was 56 days for PCNL and 30 days for URS, with associated median expenses of €3,558 (± €2,681) and €1,967 [€1,083-€3,168], respectively.</p><p><strong>Conclusion: </strong>The study found no significant differences in direct or indirect costs between PCNL and URS, suggesting both have a comparable economic impact. While factors like procedure complexity and hospitalization may affect individual costs, they do not create notable disparities. A comprehensive evaluation of both direct and indirect costs remains crucial to optimize resource allocation and support informed clinical decision-making in the healthcare system.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2503-2511"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542016","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":"Sodium-glucose co-transporter inhibitors for APOL1 kidney disease: A call for studies.","authors":"Baris Afsar, Rengin Elsurer Afsar, Yasar Caliskan, Krista L Lentine","doi":"10.1007/s11255-025-04443-z","DOIUrl":"10.1007/s11255-025-04443-z","url":null,"abstract":"<p><p>Renal risk variants in the apolipoprotein L1 (APOL1) gene confer protection against trypanosomiasis, but these risk variants (G1 and G2 variants) also predispose to kidney disease among individuals, especially from Sub-SaharanAfrica. Currently, the mechanisms of how these renal risk variants induce kidney damage are not precisely defined, but lysosomal and mitochondrial dysfunction, altered ion channel activity, altered autophagy, and disordered immunity are suggested. Currently, there is no specific treatment for APOL1 kidney disease (APOL1-KD) although several potential disease-specific therapeutic agents are being evaluated in clinical trials. Non-specific interventions include proteinuria screening, salt restriction, and renin-angiotensin-aldosterone system inhibition but are not sufficient to prevent kidney disease progression in APOL1-KD. Given the lack of specific treatment options, more efforts are necessary to reduce kidney disease progression. Sodium glucose co-transport-2 (SGLT2) inhibitors (SGLT2i) are gaining attention for benefits in proteinuric kidney diseases and exert many beneficial effects which theoretically may be beneficial in the context of APOL1-KD. These beneficial effects include but are not limited to increased natriuresis, decreased proteinuria/albuminuria, and mitochondrial dysfunction. SGLT2i have antioxidant, anti-inflammatory and anti-fibrotic effects. In the current review, we highlight the potential reasons for exploring the use of SGLT2i in APOL1-KD. Future studies are warranted to explore if SGLT2i use can provide protection in APOL1-KD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2557-2566"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557076","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":"Impact of obesity on in-hospital outcomes in peritoneal dialysis patients: insights from a nationwide analysis.","authors":"Wisit Kaewput, Charat Thongprayoon, Supawadee Suppadungsuk, Supawit Tangpanithandee, Wannasit Wathanavasin, Fawad Qureshi, Wisit Cheungpasitporn","doi":"10.1007/s11255-025-04438-w","DOIUrl":"10.1007/s11255-025-04438-w","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a growing public health concern and may influence outcomes in end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD). However, its impact on in-hospital complications, mortality, and healthcare utilization in this population remains unclear. This study aimed to assess the association between obesity and hospitalization-related outcomes in PD patients.</p><p><strong>Methods: </strong>This study was conducted using the National Inpatient Sample to identify hospitalized ESKD patients receiving PD from the year 2003 to 2018. The in-hospital treatments, outcomes, and resource utilization were compared between obese and non-obese patients, adjusting for age, sex, race, year of hospitalization, and comorbidities.</p><p><strong>Results: </strong>A total of 100,523 hospitalized ESKD patients receiving PD were included in the analysis. Of these, 9890 (9.8%) had obesity diagnosis. In the adjusted analysis, obese patients had a higher need for procedures for PD catheter adjustment or removal (OR 1.29; 95% CI 1.16-1.43), hemodialysis (OR 1.28; 95% CI 1.19-1.38), and mechanical ventilation (OR 1.29; 95% CI 1.16-1.44), compared to non-obese patients. Obesity was significantly associated with higher risk of PD peritonitis (OR 1.12; 95% CI 1.06-1.19) and fluid overload (OR 1.34; 95% CI 1.23-1.45) but lower in-hospital mortality (OR 0.84; 95% CI 0.73-0.96). There was no significant difference in length of hospital stay and hospitalization cost between obese and non-obese patients.</p><p><strong>Conclusion: </strong>Among hospitalized PD patients, obesity is associated with higher PD-related complications and increased need for interventions but is paradoxically linked to lower in-hospital mortality. These findings provide new insights into the obesity paradox in PD and highlight the need for tailored management strategies to mitigate obesity-related risks in hospitalized PD patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2595-2601"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531364","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":"The surgical technique and efficacy of a novel pure retroperitoneoscopic extravesical bladder cuff excision without intraoperative repositioning for upper tract urothelial carcinoma.","authors":"Xin Chen, Gonglin Tang, Jianing Sun, Feng Zhang, Weicheng Sun, Hongwei Zhao","doi":"10.1007/s11255-025-04414-4","DOIUrl":"10.1007/s11255-025-04414-4","url":null,"abstract":"<p><p>To evaluate the feasibility, effectiveness and therapeutic outcomes of a novel pure retroperitoneoscopic extravesical bladder cuff excision (PREBE) in patients with upper tract urothelial carcinoma (UTUC), a retrospectively comparative study between PREBE and traditional laparoscopic nephroureterectomy (TLNU) was done in a single center. We retrospectively evaluated 72 patients diagnosed with UTUC at our hospital from January 2022 to January 2024. The patients who underwent TLNU (n = 35) and PREBE (n = 37) were consecutively enrolled. The kidney and bladder cuff were retroperitoneoscopically dissected and the bladder was repaired with needle sutures under retroperitoneoscopic in the PREBE group. Demographic, perioperative, and follow-up data were collected and compared between the two groups. Both procedures were performed effectively in 72 patients without converting to open surgery. The PREBE group exhibited shorter mean operative time (P < 0.01), less mean estimated blood loss (EBL) (P < 0.01), shorter median drainage tube removal time, shorter median first postoperative defecation (FPD) time (P < 0.01) and shorter median postoperative hospital stay (P < 0.01). However, there was no statistical difference in postoperative pathological results or in the incidence of intravesical recurrence between the two groups. The mean follow-up time was 13.8 months for the PREBE group and 14.4 months for the TLNU group. The PREBE is a safe and effective treatment for patients with UTUC, avoiding intraoperative patient repositioning while offering better perioperative outcomes to those of traditional techniques.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2487-2494"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the peripheral nature of persistent sexual dysfunction associated with post-finasteride, post-SSRI and post-accutane syndromes: lessons learned from a case study.","authors":"Jackson Stachelek, Bernadette M M Zwaans, Roni Shtein, Kenneth M Peters","doi":"10.1007/s11255-025-04373-w","DOIUrl":"10.1007/s11255-025-04373-w","url":null,"abstract":"<p><strong>Purpose: </strong>Retinoids for acne, finasteride/saw palmetto for hair loss/BPH, and selective Serotonin Reuptake inhibitors (SSRIs) for depression, have all been implicated in severe, persistent sexual dysfunction that occurs after stopping these medications. The underlying mechanism of this post-drug syndrome is unknown, nor is an effective treatment available. The purpose of this investigation is to use a retrospective chart review to characterize a cohort of patients who suffer from post-drug syndrome and to determine if improvement in symptoms is feasible when focusing treatment on the peripheral nerves of the genitalia.</p><p><strong>Methods: </strong>Three male patients seen in our urology clinic were sequentially treated with high frequency electrical stimulation and low intensity extracorporeal shock wave therapy for a total of 16 weeks. Symptom improvement was assessed using the International Index of Erection Function (IIEF), the Masturbation Erection Index (MEI), global response assessment scale, corneal confocal microscopy, the FirmTech® Ring to monitor nocturnal erections pre- and post-peripheral nerve treatment and von Frey filament testing.</p><p><strong>Result: </strong>Mild-moderate erectile function improvement, mild penile sensitivity improvement, and mild nocturnal erection improvement were seen across all three patients. Peripheral neuropathy was noted in two patients via corneal confocal microscopy, however central symptoms remain.</p><p><strong>Conclusion: </strong>The post-drug syndrome appears to consist of a peripheral component which may be treatable using our regimen, as we saw overall improvement in penile sensitivity and erections following treatments. However, patients were still profoundly affected by their symptoms post-treatment and thus there is an urgent need for additional research on this syndrome.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2387-2394"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399161","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}