Investigative and Clinical Urology最新文献

{"title":"Corrigendum: Correction of the Funding. Animal models of bone metastatic prostate cancer.","authors":"Jong Hyun Tae, In Ho Chang","doi":"10.4111/icu.20230026c","DOIUrl":"10.4111/icu.20230026c","url":null,"abstract":"<p><p>This corrects the article on p. 219 in vol. 64, PMID: 37341002.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"469"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954525","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":"Aquablation versus HoLEP: Propensity score matching analysis of functional outcomes and ejaculation preservation.","authors":"Kyung Tak Oh, Jang Hwan Kim","doi":"10.4111/icu.20250055","DOIUrl":"10.4111/icu.20250055","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the clinical outcomes of Aquablation and Holmium Laser Enucleation of the Prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH), with emphasis on functional improvement, ejaculatory preservation, and perioperative safety.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed data from January 2023 to March 2024, excluding patients with follow-up shorter than 3 months. Propensity score matching was performed using age, prostate volume, and preoperative prostate-specific antigen (PSA). Pre- and postoperative outcomes included International Prostate Symptom Score, Overactive Bladder Symptom Score, maximum flow rate (Qmax), post-void residual urine volume (PVR), PSA, and MSHQ-EjD (Male Sexual Health Questionnaire-Ejaculatory Dysfunction)-based ejaculatory grading (0-3). Paired t-tests, Wilcoxon signed-rank tests, McNemar's test, and Mann-Whitney U test were applied as appropriate.</p><p><strong>Results: </strong>A total of 104 patients were included, with 34 matched pairs. Both procedures significantly improved lower urinary tract symptoms, with no significant differences in symptom score changes or PVR. HoLEP resulted in greater improvements in Qmax and PSA (p=0.011 and p<0.001, respectively). Aquablation demonstrated significantly better preservation of ejaculation (p=0.002). Although transient incontinence was more frequent in HoLEP and gross hematuria and urinary retention were more common in Aquablation, none of the complication rates showed statistically significant differences.</p><p><strong>Conclusions: </strong>Aquablation and HoLEP are both effective surgical options for BPH. Aquablation offers comparable symptom relief with significantly superior ejaculation preservation, making it particularly suitable for sexually active patients. HoLEP provides greater deobstructive efficacy, as evidenced by superior Qmax and PSA outcomes. These findings support individualized, patient-centered decision-making.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"431-438"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954553","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":"Contemporary management of metastatic urothelial carcinoma.","authors":"Jong Jin Oh, Sung Kyu Hong","doi":"10.4111/icu.20250008","DOIUrl":"10.4111/icu.20250008","url":null,"abstract":"<p><p>Urothelial carcinoma, the most common malignancy of the urinary tract, presents a significant challenge, particularly in its metastatic stage, where prognosis remains poor despite advancements in treatment. Historically, platinum-based chemotherapy has been the standard first-line therapy, achieving moderate response rates but limited long-term survival. Recent breakthroughs have introduced immune checkpoint inhibitors, antibody-drug conjugates (ADCs), and targeted therapies as more effective alternatives. Enfortumab vedotin plus pembrolizumab has demonstrated superior efficacy as a first-line treatment, improving overall survival (OS) and objective response rates compared to chemotherapy. Maintenance therapy with avelumab has further prolonged survival in patients responding to initial platinum-based chemotherapy. Additionally, sacituzumab govitecan, an ADC targeting Trop-2, and erdafitinib, a fibroblast growth factor receptor (FGFR) inhibitor, have provided promising options for patients with refractory disease or FGFR alterations. The evolving treatment paradigm now prioritizes biomarker-driven, personalized approaches over traditional chemotherapy-based regimens. However, challenges remain in optimizing treatment sequencing and managing toxicity. Future research should focus on refining patient selection criteria and exploring novel combination therapies to enhance efficacy and durability of response.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"375-382"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954489","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":"Influence of bladder outlet obstruction on age-related changes in male bladder contractility.","authors":"Jin Bong Choi, Kang Jun Cho, Joon Chul Kim, Young Kyu Han, Ju Hun Ahn, Seong Joo Yang, Jun Sung Koh","doi":"10.4111/icu.20250161","DOIUrl":"10.4111/icu.20250161","url":null,"abstract":"<p><strong>Purpose: </strong>Changes in bladder contractility due to aging are among the important causes of lower urinary tract symptoms (LUTS) in elderly males. The purpose of this study was to observe changes in bladder contractility due to aging in male patients taking medications commonly used to treat LUTS in clinical practice.</p><p><strong>Materials and methods: </strong>Male patients aged over 40 years who underwent urodynamic studies for LUTS from January 2012 to December 2024 were included. The bladder outlet obstruction (BOO) index was used to distinguish between males with BOO and those without BOO. Changes in bladder contractility according to age in each group were analyzed using the bladder contractility index. The Pearson correlation coefficient (<i>r</i>) was used to calculate the strength of the linear relationship between age and the variables.</p><p><strong>Results: </strong>A total of 449 male patients who underwent urodynamic studies for LUTS were eligible for this study (311 in the BOO group and 138 in the BOO group). Age and the maximum flow rate were inversely related in both groups. Age and bladder contractility were significantly correlated in the non-BOO group (p=0.021) but not in the BOO group (p=0.057).</p><p><strong>Conclusions: </strong>This study revealed that BOO might act as a confounding variable in measuring the contractility of an aged bladder. Excluding the effect of BOO, bladder contractility significantly decreases with age. Therefore, when male LUTS are treated, changes in bladder contractility due to aging vary depending on BOO.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"462-468"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954565","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":"Association between truncal muscle mass index measured by bioelectrical impedance analysis and overactive bladder symptoms in men: A retrospective cross-sectional analysis.","authors":"Hoyoung Bae, Jung Hoon Lee, Min Chul Cho, Hwancheol Son, Hyeon Jeong, Sangjun Yoo","doi":"10.4111/icu.20250205","DOIUrl":"10.4111/icu.20250205","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the relationship between truncal muscle mass, particularly the skeletal truncal muscle mass index (sTMI), and overactive bladder (OAB) symptoms in adult men, using bioelectrical impedance analysis (BIA).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed health screening data from 5,475 men aged ≥40 years collected between 2014 and 2022. OAB was defined as an OAB Symptom Score (OABSS) ≥3 and urgency score ≥2, with moderate-to-severe OAB defined as OABSS ≥6 and urgency score ≥2. Body composition metrics, including fat-free mass (FFM), total muscle mass (TMM), and truncal muscle mass (whole and skeletal), were measured via BIA. The sTMI was calculated by dividing skeletal truncal muscle mass by body mass index (BMI). Logistic regression and receiver operating characteristic (ROC) analyses were conducted to assess predictors of OAB.</p><p><strong>Results: </strong>The overall OAB prevalence was 10.6%. In univariate analysis, FFM (odds ratio [OR] 0.983, p=0.013), TMM (OR 0.982, p=0.010), and sTMI (OR 0.447, p=0.025) were inversely associated with OAB symptoms. However, in multivariate analysis, only sTMI remained a significant independent predictor of moderate-to-severe OAB (OR 0.486, p=0.036). ROC analysis showed that sTMI had better predictive performance for severe OAB (area under the curve [AUC] 0.721) compared to age (AUC 0.706).</p><p><strong>Conclusions: </strong>sTMI, a BIA-based index reflecting truncal skeletal muscle normalized to BMI, is an independent predictor of moderate-to-severe OAB in men. This suggests a potential role of muscle composition in OAB pathophysiology and risk stratification.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"439-447"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954510","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":"Enhancement of inter-/intra-reader agreement using the Prostate Imaging Reporting and Data System version 2.1 for prostate cancer detection in magnetic resonance imaging/transrectal ultrasound software fusion prostate biopsy.","authors":"Won Hoon Song, Tae Un Kim, Hwa Seong Ryu, Mi Sook Yun, Sung-Woo Park","doi":"10.4111/icu.20250208","DOIUrl":"10.4111/icu.20250208","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated inter-/intra-reader agreement with the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 to improve the detection rate of prostate cancer.</p><p><strong>Materials and methods: </strong>We enrolled 210 patients who underwent multiparametric magnetic resonance imaging (mpMRI) for clinically suspected or diagnosed prostate cancer. Four readers, including two urologists, viewed patients' mpMRI and scored PI-RADS between two sessions, including the time for feedback and training after the first reading session. Inter- and intra-reader agreements were evaluated using Fleiss' kappa coefficient (κ), agreement coefficient 1 (AC1), and percentage of agreement (PA).</p><p><strong>Results: </strong>The overall inter-reader agreement between all readers was moderate (κ=0.466, AC1=0.522, and PA=0.610). The overall inter-reader agreement improved in the second session. The agreement for peripheral zone (PZ) lesions was higher than that for transitional zone (TZ) lesions. At a PI-RADS cut-off of 4, the agreement for PZ lesions was almost perfect (PA=0.888) and higher than that for TZ lesions. The inter-reader agreement for lesions with a PI-RADS ≥4 and Gleason score ≥7 was almost perfect (AC1=0.960 and PA=0.964). The intra-reader agreement for lesions overall and PI-RADS ≥4 lesions were substantial (AC1=0.601) and almost perfect (PA=0.876), respectively.</p><p><strong>Conclusions: </strong>Readers achieved moderate agreement for PI-RADS version 2.1 and benefitted from training sessions. Feedback, training, and multidisciplinary discussions also improved inter-reader agreement. Our study can provide guidance, updates, and further steps for the standardization and improvement of PI-RADS scoring.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"405-415"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954528","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":"Antibiotic prophylaxis in ambulatory cystoscopy: Challenging its role even in high-risk patients-prospective observational study.","authors":"Dolev Perez, Ariel Mamber, Michael Pasherstnik, Dmitry Koulikov, Ala Eddin Natsheh, Ofer Z Shenfeld, Avital Zeldin, Benymin Tzair, Boris Chertin, Ilan Z Kafka","doi":"10.4111/icu.20250221","DOIUrl":"10.4111/icu.20250221","url":null,"abstract":"<p><strong>Purpose: </strong>Cystoscopy is a commonly performed outpatient urological procedure, with post-procedural urinary tract infections (UTIs) being a key concern. It is generally safe, but high-risk individuals (e.g., diabetics, chronic obstructive pulmonary disease [COPD], immunodeficiency) have a higher risk for potential UTIs. This study evaluates the effectiveness of antibiotic prophylaxis in preventing post-cystoscopy UTIs.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted in 2023, enrolling 300 adult patients undergoing ambulatory flexible cystoscopy who were divided into two cohorts: cystoscopy with and without antibiotic prophylaxis. The primary outcome was UTI incidence within four weeks post-procedure, defined by a positive urine culture (>10⁵ CFU/mL) and accompanying symptoms, antibiotic prescriptions, or emergency visits. Positive urine cultures confirmed the primary outcomes.</p><p><strong>Results: </strong>The study involved 300 patients: 150 received antibiotic prophylaxis (Cohort A), and 150 did not (Cohort B), showing no significant differences in clinical and demographic variables. UTI incidence was 9.3% in Cohort A and 10.0% in Cohort B, with no statistically significant difference (p=0.510). No cases of urinary sepsis were observed. Risk factors such as diabetes, ischemic heart disease, and COPD were evenly distributed across both cohorts.</p><p><strong>Conclusions: </strong>Antibiotic prophylaxis did not significantly reduce post-cystoscopy UTI rates. These findings suggest that routine prophylactic antibiotic use may be unnecessary in low-risk patients, reinforcing the need for antibiotic stewardship. Further large-scale studies are warranted to refine clinical guidelines.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"448-454"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954435","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":"The role of Uro-Vaxom in reducing infectious adverse effects and improving outcomes in bacillus Calmette-Guérin therapy for non-muscle-invasive bladder cancer.","authors":"Sookyung Cho, Ho Seok Chung, Seung Il Jung, Do Gyeong Lim, Eu Chang Hwang, Dong Deuk Kwon","doi":"10.4111/icu.20250060","DOIUrl":"10.4111/icu.20250060","url":null,"abstract":"<p><strong>Purpose: </strong>Intravesical bacillus Calmette-Guerin (BCG) instillation is a cornerstone treatment for non-muscle-invasive bladder cancer (NMIBC) but is frequently associated with significant local and systemic adverse effects. This study aimed to investigate the effects of Uro-Vaxom (UVX) on BCG-related infectious adverse events and oncologic outcomes in patients with NMIBC.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 251 NMIBC patients who underwent BCG induction therapy following transurethral resection of bladder tumors at a single institution. Patients were stratified into two groups: those not receiving UVX (non-UVX group, n=142) and those receiving UVX (UVX group, n=109). Clinical and oncologic parameters, including the frequency of antibiotic use, treatment discontinuation rates, and early recurrence rates following BCG therapy, were compared between the groups.</p><p><strong>Results: </strong>Antibiotic use during BCG treatment was significantly lower in the UVX group compared to the non-UVX group (p<0.001). Furthermore, BCG discontinuation due to urinary tract infection (UTI) was observed exclusively in the non-UVX group (p=0.003). Although tumor recurrence rates within one year were lower in the UVX group, this difference did not reach statistical significance (p=0.212). Multivariate analysis did not identify UVX use as a significant predictor of early recurrence or bacteriuria.</p><p><strong>Conclusions: </strong>The administration of UVX during BCG therapy in NMIBC patients was associated with reduced antibiotic use and a lower BCG discontinuation rate due to UTI, thereby improving treatment adherence. These findings highlight the potential role of UVX as a valuable adjunct to BCG therapy to optimize patient outcomes.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 4","pages":"344-351"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567459","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":"Letter to the editor: Combination of intrarectal heated lidocaine gel and periprostatic nerve block for pain control during transrectal ultrasound-guided prostate biopsy: A prospective randomized trial.","authors":"An Minh Nguyen, Long Hoang Vo","doi":"10.4111/icu.20250085","DOIUrl":"10.4111/icu.20250085","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 4","pages":"366-369"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567453","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":"Letter to the editor: Multi-center, prospective, non-interventional, observational study on the efficacy and safety of Mirabek^® in adult patients with overactive bladder.","authors":"An Minh Nguyen, Long Hoang Vo","doi":"10.4111/icu.20250056","DOIUrl":"10.4111/icu.20250056","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 4","pages":"361-365"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567455","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}