Investigative and Clinical Urology最新文献

{"title":"Association of initial transurethral resection staging on survival in radical cystectomy patients.","authors":"Joongwon Choi, Wan Song, Jong Kil Nam, Bumjin Lim, Wook Nam, Jong Jin Oh, Seung-Hwan Jeong, Seok Ho Kang, Tae-Hwan Kim, Ji Eun Heo, Won Sik Ham, Geehyun Song, Ho Kyung Seo, Chung Un Lee, Yong Seong Lee, Se Young Choi, Kyung Hwan Kim, Byong Chang Jeong","doi":"10.4111/icu.20250573","DOIUrl":"10.4111/icu.20250573","url":null,"abstract":"<p><strong>Purpose: </strong>Muscle-invasive bladder cancer (MIBC) is highly aggressive and presents complex treatment challenges. This study aimed to determine if the stage found during the initial transurethral resection of bladder tumor (TURBT) significantly impacts the prognosis of patients undergoing subsequent radical cystectomy (RC).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed a multi-institutional database of 3,258 RC patients treated between January 2010 and December 2019, with confirmed survival data. The analysis included 68 variables such as baseline characteristics, initial and highest TURBT pathology, and final pathology. Patients were categorized into four groups based on initial T stage: pTa, pT1, pT2, and Tis (carcinoma <i>in situ</i>).</p><p><strong>Results: </strong>The mean follow-up was 46.6±38.7 months. There were no significant differences in demographic variables between the groups. Overall survival (OS) rates differed significantly across the four groups (p=0.017). Crucially, the Tis group demonstrated the most favorable long-term outcomes, with an OS rate over 60% at 150 months. The initial pTa, pT1, and pT2 groups did not show significant OS differences among themselves.</p><p><strong>Conclusions: </strong>The initial TURBT stage is associated with the prognosis of patients undergoing RC for bladder cancer. Patients with carcinoma <i>in situ</i> (Tis) is associated with more favorable outcomes from earlier cystectomy, leading to markedly improved long-term survival. For patients with more advanced initial stages (pT1, pT2), however, final pathology and lymph node status are more predictive of survival than the initial TURBT findings.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"237-245"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814754","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":"Impact of repeated prostate-specific antigen testing on management patterns and personal healthcare spending for prostate cancer: A population-based study National Health Insurance data for 166,848 patients in South Korea from 2010 to 2020.","authors":"Young Hwii Ko, Sang Won Kim, Nak-Hoon Son","doi":"10.4111/icu.20250537","DOIUrl":"10.4111/icu.20250537","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether repeated prostate-specific antigen (PSA) testing influences treatment patterns and healthcare costs for prostate cancer (PCa).</p><p><strong>Materials and methods: </strong>We analyzed a nationwide insurance cohort of men newly registered with PCa from 2010 to 2020. Patients were classified as PSA-tested (≥3 tests across ≥2 years before registration) or PSA non-tested (first PSA test within 3 months before registration). We compared the initial and subsequent treatment patterns between localized and systemic therapies, and per-patient medical expenditures by treatment modality. The analyses focused on 2016 to 2020, when government-set prices stabilized. Primary endpoints were cumulative medical costs and downstream medical utilization patterns.</p><p><strong>Results: </strong>Of the 166,848 men, 26.7% were PSA-tested, 42.2% were non-tested, and 31.1% were undetermined. Localized therapy was more frequent after repeated testing: surgery, 45.6% versus 33.8% (p<0.001); radiotherapy, 17.0% versus 14.9% (p<0.001); and focal therapy, 0.8% versus 0.3% (p<0.001). Systemic therapy predominated without prior testing: hormone therapy, 59.7% versus 42.3% (p<0.001), chemotherapy, 2.7% versus 1.0% (p<0.001), and androgen receptor-targeted agents, 1.4% versus 0.5% (p<0.001). For localized modalities delivered during 2016 to 2020, the per-patient costs of non-robotic surgery and radiation therapy were comparable between the groups. In contrast, expenditures for hormone therapy and androgen receptor-targeted agents were significantly higher in the PSA non-tested group, primarily reflecting a longer treatment duration rather than higher monthly spending.</p><p><strong>Conclusions: </strong>Once national prices stabilized, repeated PSA testing was associated with greater use of localized therapy and lower cumulative spending on prolonged systemic treatment without increasing the costs for localized modalities.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"263-272"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815099","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":"Upregulation of aquaporin-2 and caveolins in rat bladder with outlet obstruction-induced detrusor overactivity.","authors":"Seong Hyeon Yu, Ho Seok Chung, Do Gyeong Lim, Sun-Ouck Kim","doi":"10.4111/icu.20250486","DOIUrl":"10.4111/icu.20250486","url":null,"abstract":"<p><strong>Purpose: </strong>Bladder outlet obstruction (BOO) leads to detrusor overactivity (DO) and structural remodeling of the bladder. However, the molecular mechanisms underlying this process remain incompletely understood.</p><p><strong>Materials and methods: </strong>In a rat model of partial BOO, we assessed bladder function via cystometry and evaluated histological changes using hematoxylin and eosin staining. The expression and localization of aquaporin (AQP)-2 and caveolin (CAV)-1, -2, and -3 were analyzed by Western blotting and immunofluorescence in bladder tissues. Additionally, immunostaining was performed in cultured human bladder smooth muscle cells to assess protein co-localization.</p><p><strong>Results: </strong>BOO rats exhibited elevated detrusor contraction pressure and shortened intercontraction intervals. Histologically, hypertrophied smooth muscle bundles and increased extracellular matrix were observed. Western blot analysis revealed significant upregulation of AQP2 and CAV1-3 in BOO bladders. Tissue immunofluorescence demonstrated increased expression and redistribution of these proteins in the detrusor muscle. Cultured cell analysis confirmed subcellular co-localization of AQP2 with CAV1-3.</p><p><strong>Conclusions: </strong>DO induced by BOO is associated with upregulated expression of AQP2 and CAV1-3 in the urinary bladder. The coexpression observed in bladder cells suggests potential molecular interactions between AQP2 and CAVs that may contribute to the pathophysiology of BOO-related bladder dysfunction.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"299-306"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815189","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":"Disease complexity, not surgical approach, predicts outcomes in xanthogranulomatous pyelonephritis.","authors":"Horst Emanuel Lagos-Beitz, Renee Van't Hek, Guillermo Trujillo-Martínez, Rodrigo Escalante-Armenta, Guillermo Martínez-Delgado, Gerardo Tena González-Méndez, Carlos Enrique Mendez-Probst, Ricardo Alonso Castillejos-Molina","doi":"10.4111/icu.20250640","DOIUrl":"10.4111/icu.20250640","url":null,"abstract":"<p><strong>Purpose: </strong>Xanthogranulomatous pyelonephritis (XGP) is a destructive renal infection typically requiring nephrectomy. Although laparoscopy is increasingly feasible, morbidity remains high and predictors of adverse outcomes are not well defined. We aimed to explore predictors of postoperative complications and compare laparoscopic versus open approaches.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 42 XGP nephrectomies (2014-2024) at a tertiary referral center. Demographics, imaging features, intraoperative findings, and 30-day outcomes were collected. Complications were graded by Clavien-Dindo, defining major complications as grade ≥III. Comparative analyses used nonparametric and exact tests; exploratory regression identified pre- and intraoperative predictors.</p><p><strong>Results: </strong>Median age was 47.0 years; 78.6% were females. Laparoscopy was attempted in 32 cases, with 5 conversions (15.6%). Overall, 69.0% experienced complications and 50.0% major events, but no deaths occurred. Compared with open surgery (n=10), laparoscopy showed lower transfusion requirements (34.4% vs. 60.0%) and less blood loss, while overall complication rates were similar. Hydronephrosis, perinephric/psoas abscesses, and higher blood loss were associated with increased morbidity.</p><p><strong>Conclusions: </strong>XGP nephrectomy remains a high-morbidity operation. Laparoscopy appears feasible and safe in selected cases, with trends toward reduced transfusion and blood loss. Disease complexity-rather than surgical approach-primarily drives outcomes. These exploratory findings warrant validation in multicenter studies.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"290-298"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814834","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":"Early complications within 30 days after radical cystectomy: The top seven complications and their predictors.","authors":"Sara Duarte, Eduardo Felício, Guilherme Bernardo, Filipe Gaboleiro, André Pita, Diogo Carmali, Andrea Furtado, António Pinheiro, André Barcelos, Sónia Ramos, Fernando Ferrito","doi":"10.4111/icu.20250687","DOIUrl":"10.4111/icu.20250687","url":null,"abstract":"<p><strong>Purpose: </strong>Radical cystectomy (RC) is among the most complex procedures in urology, with early morbidity rates exceeding 50%. Understanding which complications occur most often and identifying their predictors may improve perioperative optimization and postoperative surveillance. This study aimed to determine the most common complications occurring within 30 days after RC and to identify their predictors.</p><p><strong>Materials and methods: </strong>We conducted a retrospective observational study of all adult patients undergoing RC with urinary diversion at a single institution between January 2014 and December 2024. A total of 202 patients met inclusion criteria. The seven most frequent complications were identified. Univariable logistic regressions and three separate multivariable models were generated for each complication. Adjusted odds ratios with 95% confidence intervals were reported.</p><p><strong>Results: </strong>Overall, 53.0% of patients experienced at least one complication within 30 days. The seven most frequent complications were ileus (25.7%), wound complications (18.8%), urinary tract infection (UTI) (18.3%), sepsis (13.4%), evisceration (11.9%), respiratory infection (5.9%), and bowel anastomotic leak (4.5%). Ileus was predicted by intraoperative complications and urinary diversion type. Wound complications were associated with higher Charlson comorbidity index (CCI), sepsis, ileus, and open surgery. Sepsis was predicted by hypertension, advanced-stage disease, ileus, wound complications, and bowel anastomotic leak. No independent predictors were identified for early UTI. Respiratory infection was associated with postoperative ileus. Evisceration was strongly associated with CCI, intraoperative complications, ileus, and bowel anastomotic leak.</p><p><strong>Conclusions: </strong>Early morbidity after RC remains high. Predictor profiles differed across complications, supporting the need for complication-specific perioperative strategies.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"254-262"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814923","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":"Impact of carcinoma <i>in situ</i> of bladder at transurethral resection and radical cystectomy on survival: Retrospective multicenter study.","authors":"Ji Eun Heo, Jongchan Kim, Won Sik Jang, Hyun Hwan Sung, Bumjin Lim, Seung-Hwan Jeong, Jong Jin Oh, Geehyun Song, Ho Kyung Seo, Tae-Hwan Kim, Yun-Sok Ha, Wook Nam, Kyung Hwan Kim, Jong Kil Nam, Tae Il Noh, Seok Ho Kang, Byong Chang Jeong, Won Sik Ham","doi":"10.4111/icu.20250455","DOIUrl":"10.4111/icu.20250455","url":null,"abstract":"<p><strong>Purpose: </strong>Carcinoma <i>in situ</i> (CIS) of the bladder is a high-grade, non-invasive lesion known to increase the risk of recurrence and progression. However, the prognostic significance of CIS identified at transurethral resection of bladder tumor (TURB) versus radical cystectomy (RC) remains controversial. This study aimed to evaluate the impact of CIS at different treatment stages on recurrence-free survival (RFS) and cancer-specific survival (CSS).</p><p><strong>Materials and methods: </strong>A retrospective multicenter study was conducted using data from 2,553 patients who underwent TURB followed by RC between 2010 and 2019 across eleven Korean institutions. Kaplan-Meier survival curves and Cox proportional hazards models were used to assess the association of CIS at TURB and RC with RFS and CSS, adjusting for clinicopathological variables.</p><p><strong>Results: </strong>CIS was identified in 731 TURB specimens (28.6%) and 821 RC specimens (32.2%). Patients with CIS at TURB had significantly higher RFS (p<0.001) and CSS (p=0.002) compared to those without. In multivariate analysis, CIS at TURB was independently associated with better RFS (hazard ratio [HR] 0.787, p=0.001) but not CSS (HR 0.989, p=0.905). CIS at RC showed no significant association with either RFS or CSS. Independent predictors of poor survival included advanced stage, lymph node involvement, lymphovascular invasion, and positive surgical margins. Adjuvant therapy was associated with improved CSS.</p><p><strong>Conclusions: </strong>CIS at TURB is associated with a lower recurrence risk following RC, whereas CIS in RC specimens has limited prognostic impact. These findings suggest CIS at TURB may carry different prognostic implications than traditionally assumed, warranting careful clinical interpretation.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"246-253"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815041","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":"Endoscopic combined intrarenal surgery: From percutaneous nephrolithotomy to the future of stone management.","authors":"Dong Hyuk Kang, Jae Yong Jeong, Young Joon Moon, Hae Do Jung, Lawrence Kim, Joo Yong Lee","doi":"10.4111/icu.20260089","DOIUrl":"10.4111/icu.20260089","url":null,"abstract":"<p><p>The surgical management of complex renal calculi has undergone a paradigm shift from traditional prone percutaneous nephrolithotomy (PCNL) to the more versatile supine approach. This evolution paved the way for endoscopic combined intrarenal surgery (ECIRS), a technique that synergizes antegrade and retrograde access into a seamless \"four-hand\" collaboration. This review explores the historical trajectory and biomechanical advantages of ECIRS, emphasizing its role in overcoming the limitations of PCNL and retrograde intrarenal surgery monotherapies. Central to this approach is the \"intermediate-supine position,\" which facilitates real-time simultaneous operation. We highlight critical mechanisms such as the \"transport technique,\" where flexible ureteroscopy displaces inaccessible fragments toward the nephroscope, and the \"washout mechanism,\" which maintains low intrarenal pressure and ensures clear visualization. Contemporary evidence, including recent randomized trials and meta-analyses, demonstrates that ECIRS-particularly with miniaturized tracts (Mini-ECIRS)-achieves superior stone-free rates with significantly reduced morbidity compared to conventional methods. The technique proves especially advantageous for staghorn calculi and high-risk patients by enabling \"single-puncture\" clearance, thereby minimizing hemorrhagic risks associated with multiple tracts. Furthermore, the integration of robotic assistance for both renal access and retrograde manipulation is democratizing technical excellence. As we transition toward the era of \"Fully Robotic ECIRS,\" this multimodal strategy is increasingly positioned not merely as an alternative, but as a leading framework and a strong candidate for broader adoption in appropriately selected patients with for complex urolithiasis, balancing maximal clearance with minimal invasiveness.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"213-226"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815052","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":"Penile revascularization in pelvic-fracture urethral injury: Rationale, evidence, and controversies.","authors":"Jordán Scherñuk, Juan Diego Tinajero, Leonidas Karapanos, Guglielmo Mantica, Wesley Verla, Mikołaj Frankiewicz, Behzad Abbasi, Łukasz Białek, Francesco Chierigo, Jakob Klemm, Mattia Lo Re, Paul Neuville, Maciej Oszczudłowski, Elaine Redmond, Malte W Vetterlein","doi":"10.4111/icu.20260111","DOIUrl":"10.4111/icu.20260111","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"307-309"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815106","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":"Blood pressure increases and other safety and medication compliance in overactive bladder patients treated with Selebeta^® PR tablets: A noninterventional, multicenter, retrospective observational study.","authors":"Jong Hoon Lee, Aram Kim, Ji Sung Shim, Kwang Jin Ko","doi":"10.4111/icu.20250489","DOIUrl":"10.4111/icu.20250489","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the safety, including blood pressure changes, and medication compliance associated with a generic prolonged-release formulation of mirabegron (Selebeta^® PR Tab. 50 mg) in Korean adults with overactive bladder (OAB) through a large-scale, real-world, multicenter, retrospective observational study.</p><p><strong>Materials and methods: </strong>Patients with OAB who were prescribed Selebeta^® PR once daily for at least 3 months between July 2020 and July 2021 from 95 medical institutions in Korea were included. The primary endpoint was the proportion of patients with an increase in systolic blood pressure (SBP) of ≥10 mmHg after 3 months of treatment. Secondary endpoints included additional thresholds of blood pressure elevation, changes in SBP and diastolic blood pressure (DBP) and pulse rate over time, improvement in OAB symptom, incidence of adverse events, and medication compliance.</p><p><strong>Results: </strong>A total of 2,091 patients were enrolled in the study. After 3 months of treatment, 8.8% of the patients had an SBP increase of ≥10 mmHg; 3.7%, ≥15 mmHg; and 2.3%, ≥20 mmHg. DBP increased by ≥5 mmHg in 16.8% and by ≥10 mmHg in 6.7% of patients. OAB symptoms also improved significantly in the subgroup with available OAB symptom score data. The overall incidence of adverse events was 2.1%, mostly mild, and mean medication coverage was 73.6%.</p><p><strong>Conclusions: </strong>This study demonstrated that Selebeta^® PR is an effective and well-tolerated treatment for adults with OAB, with no clinically meaningful increase in blood pressure and a low incidence of adverse events.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"273-280"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814839","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":"Urinary tract infections after benign cystectomy: Incidence, risk factors, pathogens, and resistance patterns.","authors":"Maxwell Sandberg, David Thole, Randall Bissette, Dylan Wolff, Madeline Sandberg, Lindsay Schwartz, Ethan Weitzman, Robert Evans, Alejandro R Rodriguez","doi":"10.4111/icu.20250644","DOIUrl":"10.4111/icu.20250644","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary tract infections (UTIs) are a known complication after cystectomy, but patients undergoing cystectomy for benign conditions represent an understudied population. This study quantified UTI rates after benign cystectomy (BC) and identified patient factors associated with infection.</p><p><strong>Materials and methods: </strong>We reviewed all patients who underwent BC at our institution from 2012-2025, excluding those treated for malignancy. Cystectomy type and urinary diversion were recorded. UTIs required culture confirmation of >10⁵ colony-forming units and were categorized as occurring either during the immediate postoperative period before discharge or within 90 days after discharge. Demographics and perioperative characteristics were compared between patients with and without UTIs in each time frame.</p><p><strong>Results: </strong>Among 183 patients undergoing BC, 27 (14.8%) developed an immediate postoperative UTI, and 35 (19.1%) developed a UTI within 90 days. Sixty patients (32.8%) received postoperative antibiotic prophylaxis (AP). AP was not associated with lower rates of immediate postoperative UTIs, and patients who developed a UTI within 90 days were more likely to have received AP (55.9% vs. 28.1%; p<0.05). Common pathogens included <i>Enterococcus</i> species, <i>Escherichia coli</i>, and <i>Klebsiella pneumoniae</i>. Patients with immediate postoperative UTIs had longer operative times (390 minutes vs. 340 minutes; p<0.05). Those with UTIs within 90 days were more frequently readmitted (94.3% vs. 26.1%; p<0.05).</p><p><strong>Conclusions: </strong>UTIs after BC are common both immediately postoperatively and within 90 days. AP did not reduce early UTIs and were associated with higher 90-day UTI rates. Further investigation is warranted to clarify risk factors and optimize prevention strategies.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"67 3","pages":"281-289"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815171","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}