International Urology and Nephrology最新文献

{"title":"Trends and outcomes in kidney retransplantation: a 2-decade longitudinal analysis.","authors":"Abolfazl Jamshidi, Janice Liu, Sajedeh Jadidi, Emily Harland, Mahmoudreza Moein, Reza Saidi","doi":"10.1007/s11255-025-04585-0","DOIUrl":"10.1007/s11255-025-04585-0","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate kidney retransplantation outcomes to optimize patient care and reduce the risk of further retransplantation.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal analysis of the Scientific Registry of Transplant Recipients (SRTR) database for kidney retransplants performed in the United States from January 2000 to May 2023. Patients were divided into subgroups based on transplant date and number of previous transplants. Outcomes were assessed by patient and allograft survival.</p><p><strong>Results: </strong>A total of 34,230 patients were evaluated (12,224 in 2000-2011, 22,006 in 2012-2023). The proportion of DCD (donation after cardiac death) donors was significantly higher in 2012-2023 (21.3% vs. 8.8%, p < 0.001). Both patient and allograft survival improved in the more recent time frame (5-year survival: 84.8% vs. 83.7% for patients; 75.9% vs. 69.3% for allografts, p < 0.001). Allograft failure rates were higher with increasing retransplant attempts (5-year survival: 73.4% vs. 71.8% vs. 62.3% for first, second, and third + retransplants, p < 0.001). DGF increased failure risk (HR: 1.69 [1.60-1.79] in 2000-2011; HR: 1.79 [1.63-1.97] in 2012-2023), as did higher kidney donor profile index (KDPI) (HR: 1.96 [1.70-2.26] in 2000-2011; HR: 2.34 [1.82-3.01] in 2012-2023). Allograft thrombosis contribution as an etiology for failure increased (OR: 2.94 [2.20, 3.92] for the first; OR: 3.13 [1.58, 6.79] for the second + retransplants).</p><p><strong>Conclusion: </strong>Kidney retransplant outcomes have improved, but each successive transplant has a poorer prognosis. Careful patient selection and risk assessment, especially regarding high KDPI and DGF (delayed graft function), are critical. Further investigation is needed into the rising proportion of allograft thrombosis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3897-3907"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234015","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":"Increasing utilization of urethroplasty for male urethral stricture disease: analysis of in-hospital interventions in Germany from 2006 to 2023.","authors":"Roman Herout, Luka Flegar, Juliane Putz, Nicole Eisenmenger, Johannes Huber, Christian Thomas, Martin Baunacke","doi":"10.1007/s11255-025-04487-1","DOIUrl":"10.1007/s11255-025-04487-1","url":null,"abstract":"<p><strong>Purpose: </strong>There is a wide range of surgical treatments for urethral strictures. There is no information on the extent to which these procedures have been used over the past few years.</p><p><strong>Methods: </strong>We analyzed data from Diagnosis Related Groups (DRG) billing data from DESTATIS. Linear regression models were utilized for the analysis of trends over time.</p><p><strong>Results: </strong>A significant decrease of male urethral stricture cases during the study period was observed. Cases decreased from 48,020 cases in 2006 to 33,062 cases in 2023, i.e. -31%. This decline was mainly driven by the decrease in cases in the younger age group (≤ 79 years), whereas a significant increase was noted in octogenarians (+ 24%). A total of 834,476 procedures for urethral stricture disease were analyzed. In accordance with total case numbers, inpatient surgical interventions for urethral stricture disease decreased by 39% during the study period. Internal urethrotomy significantly decreased by 50% (from 41,443 in 2006 to 20,777 in 2023; p < 0.001). Likewise, urethral dilatations significantly decreased by 17% (from 14,134 in 2006 to 11,674 in 2023; p = 0.002). On the contrary, urethroplasties significantly increased by 156% (from 873 in 2006 to 2,239 in 2023; p < 0.001).</p><p><strong>Conclusion: </strong>We present contemporary data on urethral stricture disease management in Germany. Case numbers of internal urethrotomies and urethral dilatations are declining while urethroplasty is increasingly utilized as a definitive treatment for urethral stricture disease. This may reflect an optimized treatment of urethral strictures with more urethroplasties and thus fewer relapses to be treated.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3559-3565"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983636","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":"The effect of in vitro use of FSH on sperm parameters, DNA integrity, and mitochondrial membrane potential in asthenozoospermic men.","authors":"Faezeh Etebari, Mohammad Ebrahim Rezvani, Sahar Khosravi, Mahin Izadi, Esmat Mangoli","doi":"10.1007/s11255-025-04540-z","DOIUrl":"10.1007/s11255-025-04540-z","url":null,"abstract":"<p><p>Sperm motility is a key indicator of male fertility. Decreased motility, or asthenozoospermia, highlights the need for understanding male fertility challenges. This study was designed to evaluate the effects of in vitro use of follicle-stimulating hormone (FSH) on various sperm parameters, sperm DNA integrity, and mitochondrial membrane potential. Semen samples were obtained from 20 asthenozoospermic men. Each sample was divided into control and case groups. In the case group, samples were incubated with FSH at 30 mIU/mL for 1 h, while in the control group, the samples were incubated for 1 h without treatment. Sperm parameters, DNA fragmentation, and mitochondrial membrane potential were assessed in the two groups based on WHO 2021 criteria. Progressive motility and rapid progressive motility were higher in the case group compared to the control. However, FSH did not have a significant effect on morphology, viability, DNA fragmentation, or mitochondrial membrane potential in either group. In conclusion, FSH effectively enhanced sperm motility without compromising sperm DNA integrity or mitochondrial membrane potential (MMP). Therefore, FSH can be recommended as a safe and effective option for sperm selection in patients with asthenozoospermia.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3647-3653"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983122","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":"Sacubitril/valsartan affects pulmonary arterial pressure in heart failure with preserved ejection fraction and pulmonary hypertension among PD patients.","authors":"Yanhong Guo, Silu Zhao, Xuewen Zhang, Rong Gou, Liuwei Wang, Yulin Wang, Zihan Zhai, Lu Yu, Lin Tang","doi":"10.1007/s11255-025-04580-5","DOIUrl":"10.1007/s11255-025-04580-5","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary hypertension is an independent risk factor for all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients with heart failure with preserved ejection fraction (HFpEF). However, there is still no effective treatment. The aim of this study is to evaluate the efficacy and safety of sacubitril/valsartan in PD patients with HFpEF and pulmonary hypertension.</p><p><strong>Patients and methods: </strong>145 PD patients with HFpEF and pulmonary hypertension receiving sacubitril/valsartan were recruited in this study. 38 PD patients with HFpEF and pulmonary hypertension treated with angiotensin receptor blocker (ARB) were enrolled as the control group. The follow-up time was 3 months. We evaluate efficacy and safety of sacubitril/valsartan through biochemical parameters, and echocardiographic indicators, and adverse reactions.</p><p><strong>Results: </strong>At the end of follow-up, the pulmonary artery pressure was significantly lower [33.00 (23.00, 45.50) vs 48.00 (40.00, 54.00) mmHg, P < 0.001] after the treatment of sacubitril/valsartan. The percentage change of pulmonary artery pressure after the treatment of sacubitril/valsartan was significantly higher than that of ARB [-30.00 (-48.78, -8.23) vs -8.57 (-12.80, -0.85) %, P < 0.001]. As the biomarkers of heart failure, the levels N-terminal B-type natriuretic peptide precursor and cardiac troponin I were remarkably reduced after the treatment with sacubitril/valsartan. Sacubitril/valsartan can also attenuate left-ventricular remodeling among PD patients. While, ARB does not show significant advantages compared to sacubitril/valsartan.</p><p><strong>Conclusion: </strong>Our study suggested that sacubitril/valsartan treatment might be an effective treatment for PD patients with HFpEF and pulmonary hypertension.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3879-3888"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132394","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":"Duplex ultrasound compared with digital subtraction angiography in diagnosing significant stenosis of vascular access.","authors":"Ali Jawas, Mohammad Murtuza, Fikri M Abu-Zidan","doi":"10.1007/s11255-025-04588-x","DOIUrl":"10.1007/s11255-025-04588-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the diagnostic accuracy of duplex ultrasound (DUS) using peak systolic velocity (PSV), PSV ratio (PSVR), and volume flow in detecting vascular access stenosis, compared to digital subtraction angiography.</p><p><strong>Methods: </strong>A cohort of 121 patients with arteriovenous (AV) fistulas or grafts were evaluated between January 2013 and September 2013 for clinical indicators of dysfunction, including reduced thrill, weak bruit, decreased dialysis flow, high venous pressure or excessive post-dialysis bleeding using our own collective diagnostic criteria based on previously published parameters. Critical stenosis was defined as PSV >400 cm/s, PSVR >3.5, and volume flow <400 mL/min. Angiography was performed for all hemodynamically significant stenoses diagnosed by DUS.</p><p><strong>Results: </strong>Among 121 patients (mean age, 56.6 ± 17.3 years; 64% men), DUS findings included normal studies (24%), mild stenosis (9.9%), moderate stenosis (15.7%), severe stenosis (40.5%), and total occlusions (9.9%). Stenosis locations were at the anastomotic site (86.3%), the junctional (11.3%), and the venous outflow (2.5%). Critical stenosis was identified in 49 (40.5%) patients. Of 46 patients who underwent angiography, critical stenosis was confirmed in 44. DUS demonstrated a positive predictive value (PPV) of 95.6% for detecting significant stenosis, supporting its reliability in vascular access assessment. Study limitations include its small sample size, retrospective design, and limited generalizability. Furthermore, analysis was limited to positive sonographic findings precluding sensitivity/specificity assessment.</p><p><strong>Conclusion: </strong>DUS is accurate in diagnosing severe vascular access stenosis, with a PPV exceeding 95%. Its non-invasive nature and high predictive value support its use as a first-line imaging modality for vascular access evaluation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3889-3895"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199119","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":"Long-term impact of pregnancy on mortality and graft outcomes in kidney transplant recipients: a systematic review and meta-analysis.","authors":"Mehmet Kanbay, Crischentian Brinza, Lasin Ozbek, Selen Unlu, Sama Mahmoud Abdel-Rahman, Mustafa Guldan, Ozgur Aktas, Andreea Covic, Alexandru Burlacu, Adrian Covic","doi":"10.1007/s11255-025-04572-5","DOIUrl":"10.1007/s11255-025-04572-5","url":null,"abstract":"<p><strong>Background and aim: </strong>Pregnancy in kidney transplant recipients involves complex physiological changes that could potentially impact long-term graft function and survival. Despite some evidence suggesting minimal long-term effects on graft survival, conflicting results on graft function and timing-related risks highlight the need for a comprehensive review. This systematic review and meta-analysis aims to evaluate long-term impact of pregnancy on patient survival, graft failure, serum creatinine levels, estimated glomerular filtration rate (eGFR), and proteinuria in kidney transplant recipients.</p><p><strong>Materials and methods: </strong>We conducted a systematic review and meta-analysis adhering to PRISMA guidelines and registered with PROSPERO (CRD42024569702). We searched PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MEDLINE. Studies were eligible if they provided data on adult kidney transplant recipients (> 18 years) who became pregnant post-transplant and included a control group of non-pregnant or non-conceived individuals.</p><p><strong>Results: </strong>Among the 6118 results screened, 19 studies met the eligibility criteria and were included in the meta-analysis. The risk of allograft failure or graft loss was similar between pregnant and non-pregnant controls (OR 1.13, 95% CI 0.83-1.53, p = 0.43), with a slightly higher adverse outcome rate in pregnant patients (25.4 vs. 19.8%). All-cause mortality risk was also comparable (OR 0.63, 95% CI 0.38-1.07, p = 0.09), with low heterogeneity (I² = 12%). Creatinine levels were significantly lower before pregnancy compared to after delivery (SMD - 0.33, 95% CI - 0.52 to - 0.14, p = 0.0008).</p><p><strong>Conclusion: </strong>Pregnancy in kidney transplant recipients leads to increased creatinine levels in postpartum but does not significantly affect long-term graft survival. While creatinine levels generally decrease during pregnancy, they show variability by trimester. The risk of allograft failure and mortality is similar between pregnant and non-pregnant recipients though adverse outcomes are slightly more frequent in pregnant patients, emphasizing the need for an optimal follow-up protocol of pregnant transplant recipients that takes trimester-specific graft function variations into consideration and that establishes clear thresholds for further evaluation and timely intervention.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3773-3786"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009564","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":"Therapeutic goals for mitigating chronic kidney disease progression in kidney transplant recipients: a 2024 update.","authors":"Moisés Carminatti, Helio Tedesco-Silva, Helady Sanders-Pinheiro","doi":"10.1007/s11255-025-04575-2","DOIUrl":"10.1007/s11255-025-04575-2","url":null,"abstract":"<p><strong>Purpose: </strong>In addition to allogeneic factors, kidney transplant recipients (KTR) remain exposed to non-allogeneic conditions, such as hypertension, proteinuria, anemia, bone mineral disorder, metabolic acidosis and hyperuricemia. These conditions contribute to the progression of chronic kidney disease (CKD). This paper reviews the latest updates on therapeutic goals and strategies to address these non-allogeneic risk factors.</p><p><strong>Methods: </strong>We undertook a literature review regarding the current recommendations and therapeutic targets for the treatment of non-allogeneic risk factors for CKD progression in KTR, as of 2024.</p><p><strong>Results: </strong>As evidence is limited, some factors' treatment is based on native CKD. Well supported by studies on KTR, the blood pressure target should be below 130/80 mmHg, and proteinuria ideally be kept under 500 mg/day, whenever possible due to its multifactorial nature, preferably through the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Revised optimal haemoglobin levels, and newly updated recommendations regarding treatment at earlier stages of bone mineral disorders, as well as other metabolic features and non-pharmacological interventions, are further addressed. A multidisciplinary approach with an individualized focus on treatment priorities for each patient leads to better therapeutic adherence and potentially improved outcomes.</p><p><strong>Conclusion: </strong>We summarize the updated treatment goals for CKD in KTR, which are feasible to apply in daily practice and can contribute to better long-term patient and graft function survival.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3709-3712"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110480","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":"Hepatitis C virus among hemodialysis patients: burden, risks, and prevention in resource-limited regions.","authors":"Sakhr Alshwayyat, Hamdah Hanifa, Noor Almasri, Zaid Taimeh, Yamen Alshwaiyat, Tarek Khdair, Maamoun Alfawares, Basil Alsaleh, Nihad Assaf","doi":"10.1007/s11255-025-04555-6","DOIUrl":"10.1007/s11255-025-04555-6","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) poses a significant health risk to hemodialysis patients because of their increased susceptibility to infection, especially in resource-limited environments. HCV infection can result in severe complications such as liver failure and higher mortality rates. This study evaluated the prevalence of HCV infection among patients undergoing hemodialysis and identified critical risk factors to enhance targeted prevention strategies.</p><p><strong>Methods: </strong>A cross-sectional, observational study was conducted at Damascus Hospital and Surgical Kidney Hospital between 2017 and 2022 to assess HCV prevalence and associated risk factors in hemodialysis patients. Data included demographics, dialysis duration, dialysis route, history of blood transfusion, liver function test results, and anti-HCV antibody results. Statistical analyses were performed using chi-square tests, ANOVA, and t-tests.</p><p><strong>Results: </strong>Of the 200 hemodialysis patients, 24% tested positive for HCV virus. Infection rates were significantly higher in patients with longer dialysis durations (p = 0.001), double-lumen catheter use (32.5% of the sample), and history of blood transfusions (20% of the sample). Patients who primarily underwent AV fistula dialysis showed comparatively lower infection risk. Additionally, demographic factors such as urban residency and older age were observed in a higher proportion of HCV-positive patients, although the difference was not statistically significant.</p><p><strong>Conclusion: </strong>This study highlighted a significant HCV burden among hemodialysis patients, with infection risk correlating with dialysis duration, blood transfusion history, and catheter type. These findings underscore the need for consistent infection control measures and targeted interventions to reduce HCV transmission and improve patient outcomes, especially in regions with limited healthcare resources.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3725-3731"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966336","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":"Exploring the influencing factors of abdominal aortic calcification events in chronic kidney disease (CKD) and non-CKD patients based on interpretable machine learning methods.","authors":"Haowen Lin, Xiaoying Dong, Yuhe Yin, Qingqing Gao, Siqi Peng, Zewen Zhao, Sijia Li, Renwei Huang, Yiming Tao, Sichun Wen, Bohou Li, Qiong Wu, Ting Lin, Hao Dai, Feng Wen, Zhuo Li, Lixia Xu, Jianchao Ma, Zhonglin Feng, Shuangxin Liu","doi":"10.1007/s11255-025-04564-5","DOIUrl":"10.1007/s11255-025-04564-5","url":null,"abstract":"<p><strong>Background: </strong>Calcification is prevalent in CKD patients, with abdominal aortic calcification (AAC) being a strong predictor of coronary calcification. We aimed to identify key calcification factors in CKD and non-CKD populations using machine learning models.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES), including demographics, blood and urine tests, and AAC scores, were analyzed using machine learning models. The Shapley additive explanations (SHAP) analysis was applied to interpret the models.</p><p><strong>Results: </strong>Among 505 CKD and 2,582 non-CKD participants, common key factors for calcification included age, estimated glomerular filtration rate (eGFR), smoking history, blood glucose levels (Glu), Ca*P and the urine albumin-to-creatinine ratio (UACR). Age, smoking history and eGFR were the top-ranking features in the model for both two groups. Inflammatory markers such as monocyte-to-lymphocyte ratio (MHR), monocyte-to-high-density lipoprotein ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) were more significant in CKD group. Trigger points for AAC events were identified: in CKD, eGFR of 90 mL/min/1.73 m², MHR values of 0.5 and 0.75, MLR values of 0.25, and SP of 120 mmHg; in non-CKD, eGFR of 105 mL/min/1.73 m², Ca*P values of 40, UACR values of 10, and TG of 200 mg/dL.</p><p><strong>Conclusions: </strong>Regardless of CKD status, age, smoking history, and eGFR are key determinants of calcification. In the CKD population, inflammatory markers are more significant than in the non-CKD group.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3787-3798"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002606","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":"Comparative efficacy of autologous adult live cultured buccal epithelial cells (AALBEC) and minced buccal mucosal graft endourethral urethroplasty (MBGEU) in male urethral stricture.","authors":"Kirti Singh, Abhay Singh Gaur, Swarnendu Mandal, Vivek Tarigopula, Manoj Kumar Das, Sambit Tripathy, C Sabique, Kalandi Barik, Prasant Nayak","doi":"10.1007/s11255-025-04526-x","DOIUrl":"10.1007/s11255-025-04526-x","url":null,"abstract":"<p><strong>Purpose: </strong>To conduct a comparative analysis of autologous adult live cultured buccal epithelial cells (AALBEC) and minced buccal mucosal graft endourethral urethroplasty (MBGEU) in treatment of bulbar urethral stricture disease (USD) by evaluating and comparing their efficacy, safety, and patient outcomes.</p><p><strong>Methods: </strong>This study was conducted in a tertiary-care center and included 90 males with primary, < 4 cm bulbar USD. In AALBEC arm (30 patients), AALBEC was implanted after DVIU. While in the MBGEU arm (60 patients), a 1 × 1 cm buccal mucosal graft was harvested, minced, centrifuged, and suspended in fibrin glue, and after DVIU, the suspension was instilled via a 5-Fr ureteric catheter over the urethrotomy site. The primary objective was to compare success rates. The secondary objectives were to compare changes in the American Urological Association (AUA) symptom score, peak flow rate (Qmax), and post-void residue (PVRU) post-operatively and also to look for any adverse events related to surgery.</p><p><strong>Results: </strong>The success rate of AALBEC was 73.33% and of MBGEU was 90% at 6 months (p 0.041). The stricture recurred in eight and six patients, respectively. Although both groups showed a significant increase in Qmax compared to preoperative values, MBGEU group demonstrated significantly greater improvement in Qmax at 3 months (p 0.002) and 6 months (p < 0.0001) compared to the AALBEC group. No significant donor site morbidity was seen. In AALBEC group, two patients had sepsis in postoperative period.</p><p><strong>Conclusion: </strong>The medium-term success of MBGEU is encouraging over AALBEC. However, a longer follow-up and further studies with a larger sample size are required.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3567-3575"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035250","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}