Investigative and Clinical Urology最新文献

{"title":"Evaluating prostate cancer diagnostic methods: The role and relevance of digital rectal examination in modern era.","authors":"Younsoo Chung, Sung Kyu Hong","doi":"10.4111/icu.20240456","DOIUrl":"https://doi.org/10.4111/icu.20240456","url":null,"abstract":"<p><p>This review examines diagnostic methods for prostate cancer, focusing on the role of digital rectal examination (DRE) alongside modern advancements like prostate-specific antigen (PSA) testing, Prostate Health Index (PHI), magnetic resonance imaging (MRI), and prostate-specific membrane antigen positron emission tomography (PSMA-PET), particularly in the context of Korea's aging population and healthcare challenges. Technological advancements have significantly improved prostate cancer diagnosis. PSA testing, while widely used, suffers from low specificity, often resulting in unnecessary biopsies. PHI addresses PSA's limitations, offering enhanced accuracy, particularly in the \"gray zone\" of PSA levels. MRI has revolutionized diagnostic precision, enabling detailed staging and targeted biopsies, but its cost and limited availability restrict widespread use. Emerging tools like PSMA-PET and AI (artificial intelligence)-driven diagnostics promise further improvements but remain costly and complex, limiting their routine application. Despite these advancements, DRE continues to serve as an accessible and cost-effective tool, particularly in low-resource settings or where advanced diagnostics are unavailable. In Korea, where prostate cancer is often diagnosed at more aggressive stages, and universal health insurance emphasizes cost efficiency, DRE retains value as part of a multimodal approach. Concerns about DRE's reproducibility and discomfort remain, but its utility in specific high-risk populations justifies its inclusion in diagnostic strategies. DRE, despite its limitations, remains a valuable tool in Korea's prostate cancer diagnostic landscape, particularly within a comprehensive, cost-effective, and context-sensitive screening strategy.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"181-187"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010078","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":"Optimizing extraction of microbial DNA from urine: Advancing urinary microbiome research in bladder cancer.","authors":"Chuang-Ming Zheng, Ho Won Kang, Seongmin Moon, Young Joon Byun, Won Tae Kim, Yung Hyun Choi, Sung-Kwon Moon, Xuan-Mei Piao, Seok Joong Yun","doi":"10.4111/icu.20240454","DOIUrl":"https://doi.org/10.4111/icu.20240454","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate and optimize microbial DNA extraction methods from urine, a non-invasive sample source, to enhance DNA quality, purity, and reliability for urinary microbiome research and biomarker discovery in bladder cancer.</p><p><strong>Materials and methods: </strong>A total of 302 individuals (258 with genitourinary cancers and 44 with benign urologic diseases) participated in this study. Urine samples were collected via sterile catheterization, resulting in 445 vials for microbial analysis. DNA extraction was performed using three protocols: the standard protocol (SP), water dilution protocol (WDP), and chelation-assisted protocol (CAP). DNA quality (concentration, purity, and contamination levels) was assessed using NanoDrop spectrophotometry. Microbial analysis was conducted on 138 samples (108 cancerous and 30 benign) using 16S rRNA sequencing. Prior to sequencing on the Illumina MiSeq platform, Victor 3 fluorometry was used for validation.</p><p><strong>Results: </strong>WDP outperformed other methods, achieving significantly higher 260/280 and 260/230 ratios, indicating superior DNA purity and reduced contamination, while maintaining reliable DNA yields. CAP was excluded due to poor performance across all metrics. Microbial abundance was significantly higher in WDP-extracted samples (p<0.0001), whereas SP demonstrated higher alpha diversity indices (p<0.01), likely due to improved detection of low-abundance taxa. Beta diversity analysis showed no significant compositional differences between SP and WDP (p=1.0), supporting the reliability of WDP for microbiome research.</p><p><strong>Conclusions: </strong>WDP is a highly effective and reliable method for microbial DNA extraction from urine, ensuring high-quality and reproducible results. Future research should address sample variability and crystal precipitation to further refine microbiome-based diagnostics and therapeutics.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"272-280"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024154","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":"PDK4 expression and tumor aggressiveness in prostate cancer.","authors":"Eun Hye Lee, Yun-Sok Ha, Bo Hyun Yoon, Minji Jeon, Dong Jin Park, Jiyeon Kim, Jun-Koo Kang, Jae-Wook Chung, Bum Soo Kim, Seock Hwan Choi, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, Tae Gyun Kwon","doi":"10.4111/icu.20240434","DOIUrl":"https://doi.org/10.4111/icu.20240434","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate cancer ranks as the second most common cancer in men globally, representing a significant cause of cancer-related mortality. Metastasis, the spread of cancer cells from the primary site to distant organs, remains a major challenge in managing prostate cancer. Pyruvate dehydrogenase kinase 4 (PDK4) is implicated in the regulation of aerobic glycolysis, emerging as a potential player in various cancers. However, its role in prostate cancer remains unclear. This study aims to analyze PDK4 expression in prostate cancer cells and human samples, and to explore the gene's clinical significance.</p><p><strong>Materials and methods: </strong>PDK4 expression was detected in cell lines and human tissue samples. Migration ability was analyzed using Matrigel-coated invasion chambers. Human samples were obtained from the Kyungpook National University Chilgok Hospital.</p><p><strong>Results: </strong>PDK4 expression was elevated in prostate cancer cell lines compared to normal prostate cells, with particularly high levels in DU145 and LnCap cell lines. PDK4 knockdown in these cell lines suppressed their invasion ability, indicating a potential role of PDK4 in prostate cancer metastasis. Furthermore, our results revealed alterations in epithelial-mesenchymal transition markers and downstream signaling molecules following PDK4 suppression, suggesting its involvement in the modulation of invasion-related pathways. Furthermore, PDK4 expression was increased in prostate cancer tissues, especially in castration-resistant prostate cancer, compared to normal prostate tissues, with PSA and PDK4 expression showing a significantly positive correlation.</p><p><strong>Conclusions: </strong>PDK4 expression in prostate cancer is associated with tumor invasion and castration status. Further validation is needed to demonstrate its effectiveness as a therapeutic target.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"227-235"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965581","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":"Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group.","authors":"Daniele Castellani, Bhaskar Kumar Somani, Khi Yung Fong, Steffi Kar Kei Yuen, Chin Tiong Heng, Mohamed Elshazly, Karl Tan, Thomas R W Herrmann, Olivier Traxer, Vineet Gauhar","doi":"10.4111/icu.20250071","DOIUrl":"https://doi.org/10.4111/icu.20250071","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones.</p><p><strong>Materials and methods: </strong>Five hundred forty adults were prospectively enrolled across 25 centers (from April 2023 to January 2024). Patients were divided into group 1 (overnight ureteric catheter), and group 2 (double J stent). Surgeons could choose either modality as per their discretion. One-to-one propensity score-matching for age, sex, pre-stenting, Hounsfield units, stone volume and location was performed. Thirty-day computed tomography scan was done to estimate stone-free status.</p><p><strong>Results: </strong>After matching, 120 patients were included in each group. Group 1 had significantly shorter lasing, ureteroscopy, surgical time. Median day 1 loin pain score was similar (1 [1, 2] in both groups). Median postoperative stay was shorter in group 1 (0 days [0, 1] vs. 1 day [0, 2], p<0.001). One patient in group 2 required a blood transfusion. Incidence of fever was similar (5.0% vs. 0.8%). Loin/abdominal pain requiring medication occurred in one patient in group 2. Stent-related symptoms occurred in 2 patients in group 1. Three patients (2.5%) in group 1 and 2 patients (1.7%) in group 2 required readmission. Thirty-day stone-free status was higher in group 1 patients (79.2% vs. 56.7%).</p><p><strong>Conclusions: </strong>In selected patients after thorough inspection to ensure no injury or residual fragments remain, placing an overnight ureteric catheter can be a safe alternative to a double J stent.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"236-244"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008625","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":"Assessment of artificial intelligence performance in answering questions on onabotulinum toxin and sacral neuromodulation.","authors":"Ibrahim Hacibey, Ahmet Halis","doi":"10.4111/icu.20250040","DOIUrl":"https://doi.org/10.4111/icu.20250040","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the performance of three artificial intelligence (AI) models-ChatGPT, Gemini, and Copilot-in addressing clinically relevant questions about onabotulinum toxin and sacral neuromodulation (SNM) for the management of overactive bladder (OAB).</p><p><strong>Materials and methods: </strong>A set of 30 questions covering mechanisms of action, indications, contraindications, procedural details, efficacy, and safety profiles was posed to each AI model. Responses were assessed by a panel of four urology specialists using predefined criteria: accuracy, completeness, clarity, and consistency. A multi-dimensional scoring framework evaluated the performance across five dimensions: factual accuracy, relevance, clarity/coherence, structure, and utility. Responses were scored on a 4-point Likert scale, and statistical analyses were conducted using one-way ANOVA to compare model performance.</p><p><strong>Results: </strong>ChatGPT achieved the highest mean score (3.98/4) across all dimensions, with statistically significant differences compared to Gemini (3.20/4) and Copilot (2.60/4) (p=0.001 for all dimensions). ChatGPT excelled particularly in clinical application, procedure, and safety categories, consistently delivering accurate and comprehensive answers. No statistically significant differences were found between Gemini and Copilot in most categories.</p><p><strong>Conclusions: </strong>ChatGPT demonstrated superior performance in generating accurate, complete, and clinically relevant responses for OAB management, highlighting its potential as a reliable tool for both healthcare professionals and patients. However, the variability observed in Gemini and Copilot underscores the need for further refinement of these models. Future studies should explore real-world integration of AI models into clinical workflows to enhance patient care and decision-making.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"188-193"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002450","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":"Accounting for the learning curve effect in surgical trials: Post-hoc analysis of the prophylactic use of biologic mesh in ileal conduit (PUBMIC) trial.","authors":"Alireza Ghoreifi, Rashid K Sayyid, Farshad Sheybaee Moghaddam, Hooman Djaladat","doi":"10.4111/icu.20250030","DOIUrl":"https://doi.org/10.4111/icu.20250030","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"281-283"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990717","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":"Arthritis increases the risk of prostate cancer: Results from the National Health and Nutrition Examination Survey 2005-2018 and two-sample Mendelian randomization analysis.","authors":"Xiaobin Yuan, Ruikang Shi, Qiang Jing, Xiaoming Cao, Xuhui Zhang","doi":"10.4111/icu.20240313","DOIUrl":"https://doi.org/10.4111/icu.20240313","url":null,"abstract":"<p><strong>Purpose: </strong>It was aimed to clarify the casual connection between prostate cancer (PCa) and arthritis by utilizing two-sample Mendelian randomization (MR) analysis and data from National Health and Nutrition Examination Survey (NHANES) database.</p><p><strong>Materials and methods: </strong>This study utilized NHANES data. Through association analysis and risk stratification analysis, the association between arthritis and PCa were examined. MR analysis was performed to elucidate the causal relationship between arthritis and PCa. Sensitivity analysis and Steiger directionality test confirmed the reliability of the MR analysis results.</p><p><strong>Results: </strong>A total of 23,608 (PCa:controls=413:23,195) participants after a sample exclusion and variable definition process were screened in NHANES database. Adjustments across three diverse models consistently revealed a notable influence of arthritis on PCa progression. Arthritis was identified as a risk factor for PCa (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.36-2.62, p<0.001). Subsequent analysis indicated that in the arthritis-adjusted model with multiple covariates, the area under the curve of the receiver operating characteristic curve was 0.94. The inverse variance weighting method of MR analysis showed a causal relationship between rheumatoid arthritis (RA) and PCa (OR 1.090, 95% CI 1.053-1.128, p<0.001) as well as osteoar-thritis and PCa (OR 1.002, 95% CI 1.001-1.004, p=0.002). This suggested that RA and osteoarthritis were risk factors for PCa. The heterogeneity (p>0.05), horizontal pleiotropy (p>0.05), leave-one-out and Steiger test confirmed reliability of MR results.</p><p><strong>Conclusions: </strong>NHANES database and MR analyses identified arthritis as a risk factor for PCa, offering fresh avenues for preventive and therapeutic approaches.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"215-226"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990719","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":"Correlation of shear wave elastography with histopathological grade, tumor stage, and microvessel density in bladder cancer.","authors":"Gokhan Sahin, Hakan Gemalmaz, Mustafa Gok","doi":"10.4111/icu.20250068","DOIUrl":"https://doi.org/10.4111/icu.20250068","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the pathological correlation and prognostic significance of tissue stiffness measured by shear wave elastography (SWE) in bladder cancer.</p><p><strong>Materials and methods: </strong>Patients with microscopic or macroscopic hematuria diagnosed with bladder tumors were included. SWE measurements were performed using a Samsung Medison RS80A Prestige ultrasonography device, with ten valid measurements taken for each tumor. Tumor specimens were collected via transurethral resection (transurethral resection of the bladder tumor) for histopathological analysis. Microvessel density (MVD) was assessed by immunohistochemical staining with anti-CD34 antibody using the hot-spot method. Correlations between tissue stiffness, MVD and tumor stage and grade were analyzed, and receiver operating characteristic (ROC) analysis determined the optimal SWE cutoff for differentiating tumor characteristics.</p><p><strong>Results: </strong>A total of 65 bladder urothelial carcinoma patients were included in the study (43 high-grade, 22 low-grade). SWE and MVD were significantly higher in the high-grade group (p=0.001, p=0.002, respectively). ROC analysis showed SWE could differentiate tumor grades (area under ROC curve=0.837, p<0.001), with a cut-off of 4.25 kPa (74% sensitivity, 86% specificity). Stiffness was also higher in recurrence (p=0.007). A strong positive correlation between SWE and MVD was found (rho=0.767, p<0.001). SWE may be a reliable, non-invasive tool for assessing tumor grade and recurrence risk.</p><p><strong>Conclusions: </strong>SWE may be a reliable, non-invasive preoperative marker for bladder cancer, aiding in tumor characterization and clinical decision-making.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"207-214"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981138","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":"Effect of long-term postoperative OM-89 administration on bacteriuria from suspected infectious stones.","authors":"Seung-Ju Lee, Jemo Yoo, Hee Youn Kim, Jin Bong Choi, Dong Sup Lee","doi":"10.4111/icu.20250086","DOIUrl":"https://doi.org/10.4111/icu.20250086","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the effect of long-term oral OM-89 therapy on the urinary microflora in patients with urolithiasis.</p><p><strong>Materials and methods: </strong>Patients underwent surgical removal of urinary stones followed by no OM-89 treatment for six months or daily OM-89 administration. Urine culture and urinary polymerase chain reaction (PCR) were performed at the baseline visit (V1) and at 2 months (V2) and 6 months (V3) after the operation.</p><p><strong>Results: </strong>A total of 113 patients completed the study. The rate of urinary bacteria detection by urine culture at V3 did not differ between OM-89 treated and untreated groups (p>0.999); however, the PCR detection rate tended to be higher in OM-89 untreated group than in OM-89 treated group (p=0.052). <i>Escherichia coli</i> and <i>Enterococcus</i> spp. were the bacteria most commonly detected via both urine culture and PCR at all timepoints. Risk factors for the detection of bacteria by urine culture at V3 were positive culture at V1 (p=0.048) and female sex (p=0.048), whereas positive PCR at V3 was associated with female sex (p=0.023), positive PCR at V2 (p<0.001), and no OM-89 treatment (p=0.038). The use of OM-89 was associated with decreased rates of bacterial detection by PCR at V2 and a further decrease at V3.</p><p><strong>Conclusions: </strong>Long-term immunization with OM-89 could further decrease the frequency of urinary bacterial colonization after surgical removal of urinary stones. OM-89 could be used as a complementary therapy if a retrieved stone is suspected to be related to infection.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"261-271"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966342","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":"Relationship between use of desmopressin in male patients with lower urinary tract symptoms and occurrence of hyponatremia: A nationwide population-based study using the National Health Insurance Service database.","authors":"Byeong Jo Jeon, Bum Sik Tae, Jae Young Park, Jae Hyun Bae","doi":"10.4111/icu.20240433","DOIUrl":"https://doi.org/10.4111/icu.20240433","url":null,"abstract":"<p><strong>Purpose: </strong>Desmopressin, frequently prescribed for nocturia, is associated with an elevated risk of hyponatremia. This study examined the incidence and risk factors of hyponatremia in male patients with benign prostatic hyperplasia using nationwide Korean health data.</p><p><strong>Materials and methods: </strong>From the National Health Insurance Service database, we analyzed data on desmopressin and hyponatremia in Korean adults with benign prostatic hyperplasia between 2011 and 2012. The patients were followed-up until December 2020. We tested the effects of desmopressin on hyponatremia risk using propensity score-matched Cox regression models and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Among 33,533 patients, the incidence of hyponatremia was 6.0%, 4.5%, and 5.0% in the desmopressin, alpha-blocker, and combination therapy groups, respectively. After propensity score matching, desmopressin use was not significantly associated with an increased risk of hyponatremia (hazard ratio 1.273, 95% confidence interval 0.988-1.640; p=0.062). Significant predictors of hyponatremia included advanced age, chronic heart failure, peripheral vascular disease, and renal disease.</p><p><strong>Conclusions: </strong>Desmopressin prescription following careful patient selection and regular monitoring does not significantly increase the risk of hyponatremia compared to other lower urinary tract symptom treatments. Therefore, it remains a viable and effective option for managing nocturia, particularly in patients with nocturnal polyuria. However, clinicians should implement routine monitoring protocols, including serum sodium checks, particularly in high-risk populations, to ensure the safe and effective use of desmopressin.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 3","pages":"245-250"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996301","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}