Journal of Urology最新文献

{"title":"Editorial Comment.","authors":"Lexiaochuan Wen, Roger Li","doi":"10.1097/JU.0000000000004550","DOIUrl":"10.1097/JU.0000000000004550","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"31"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD07-01 Bladder Shape Does Not Correlate With Upper and Lower Urinary Tract Findings in Children With Spina Bifida: Erratum.","authors":"Zoe S Gan, Joey Logan, Ariana L Smith, Christopher J Long, Dana A Weiss, Jason Van Batavia, Stephen A Zderic, John Weaver, Gregory E Tasian","doi":"10.1097/JU.0000000000004537","DOIUrl":"https://doi.org/10.1097/JU.0000000000004537","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":"214 1","pages":"112"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermediate-Term Oncologic Outcomes of Partial Nephrectomy vs Cryoablation in Renal Tumors > 3 cm: A Propensity Score-Matched Analysis.","authors":"Nicholas A Pickersgill, Joel M Vetter, Dylan J Mittauer, Lauren Elson, Joshua K Palka, Nimrod S Barashi, Eric H Kim, Ramakrishna Venkatesh, Sam B Bhayani, R Sherburne Figenshau","doi":"10.1097/JU.0000000000004524","DOIUrl":"10.1097/JU.0000000000004524","url":null,"abstract":"<p><strong>Purpose: </strong>Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments of small renal masses. While guidelines list thermal ablation as an option for tumors < 3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses > 3 cm.</p><p><strong>Materials and methods: </strong>Patients treated with PN or CA for cT1/cT2, N0M0 renal masses > 3 cm between 2006 and 2016 were identified. Propensity score matching was performed in a 1:2 ratio for patients undergoing CA or PN based on age, BMI, Charlson Comorbidity Index, tumor size, and nephrometry score. Disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival were estimated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>One hundred thirteen and 57 patients underwent PN and CA with a median follow-up of 4.5 and 3.8 years, respectively. CA was associated with significantly lower 5-year DFS compared with PN (75% vs 94%, <i>P</i> < .001). Local recurrence was more common after CA compared with PN (5.3% vs 1.8%). Technical failure occurred with 32% of CA. However, no significant differences were observed in 5-year MFS (100% for CA vs 96% for PN, <i>P</i> = .2) or CSS (100% for CA vs 98% for PN, <i>P</i> = .4).</p><p><strong>Conclusions: </strong>CA is associated with lower DFS but similar MFS and CSS compared with PN in renal masses > 3 cm. CA is a viable option for well-selected patients with comorbidities or high surgical risk, when combined with salvage ablation as indicated.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"32-40"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply by Authors.","authors":"Owen Lewer, Michael D Felice, Olivia Copelan, Sarang Janakiraman, Gaurav Pahouja, Amy Wozniak, Kevin T McVary","doi":"10.1097/JU.0000000000004549","DOIUrl":"10.1097/JU.0000000000004549","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"56"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Detection of Prostate Cancer: AUA/SUO Guideline Part I: Prostate Cancer Screening: Erratum.","authors":"John T Wei, Daniel Barocas, Sigrid Carlsson, Fergus Coakley, Scott Eggener, Ruth Etzioni, Samson W Fine, Misop Han, Sennett K Kim, Erin Kirkby, Badrinath R Konety, Martin Miner, Kelvin Moses, Merel G Nissenberg, Peter A Pinto, Simpa S Salami, Lesley Souter, Ian M Thompson, Daniel W Lin","doi":"10.1097/JU.0000000000004546","DOIUrl":"https://doi.org/10.1097/JU.0000000000004546","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":"214 1","pages":"111"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Excretory-Phase Computerized Tomography Important for Evaluation of Pediatric High-Grade Renal Trauma?","authors":"Ching Man Carmen Tong, Luke Shumaker, Jacob Lucas, Vinaya Bhatia, Albert Lee, Benjamin Abelson, Gabriella L Crane, Christina Ho, Christopher J Long, Robert T Russell, Harold N Lovvorn, Ming-Hsien Wang, Dana A Weiss, Douglass B Clayton, David M Kitchens","doi":"10.1097/JU.0000000000004515","DOIUrl":"10.1097/JU.0000000000004515","url":null,"abstract":"<p><strong>Purpose: </strong>There are no standardized guidelines for evaluation of pediatric renal trauma. We hypothesize that screening radiographic studies performed to rule out traumatic renal injuries in children can initially be evaluated by contrast-enhanced CT scans that lack an excretory phase.</p><p><strong>Materials and methods: </strong>We retrospectively collected data from 5 pediatric trauma centers between 2007 and 2020. Patients younger than 18 years with American Association for the Surgery of Trauma grade 3 or higher renal trauma were included. Outcomes data included rate for delayed surgical or radiologic interventions, complications, or readmissions related to the initial renal injuries.</p><p><strong>Results: </strong>Three hundred fifty-one children were included. Thirty-six percent (127/351) had excretory-phase CT (EPCT) at initial evaluation. The median age was 13.6 (IQR, 9.1-16.3) years. Grade IV/V injury was present in 56.7% (72/127) of EPCT patients vs 53.6% (120/224) of patients with nonexcretory-phase CT (NEPCT; <i>P</i> = .3). Ninety-six percent (338/351) were blunt injuries. NEPCT patients had higher median injury severity scores (21 vs 16, <i>P</i> < .01). EPCT children did not have more urinary drainage procedures (ureteral stent or percutaneous drain; 18% vs 12%, <i>P</i> = .11). Patients with initial NEPCT did not experience longer hospital stay (<i>P</i> = .46), increased complications (<i>P</i> = .52), or readmissions (<i>P</i> = .54). Importantly, gross hematuria (GH) significantly predicted need for renal procedures (odds ratio = 2.06, 95% CI, 1.28-5.2, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Patients with initial NEPCT did not experience increased adverse outcomes or readmission. Those presenting with GH had increased risk of higher-grade renal injury and need for a renal procedure. This study suggests that high-grade pediatric renal trauma can be safely evaluated with NEPCT in initial trauma workup unless they present with GH.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"69-79"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Testosterone Level and Metastases-Free Survival in Patients With Nonmetastatic Castration-Resistant Prostate Cancer Treated With Novel Antiandrogens: A Post Hoc Analysis of SPARTAN and ARAMIS.","authors":"Xudong Ni, Jixinnan Sui, Beihe Wang, Hongkai Wang, Stephen J Freedland, Dingwei Ye, Yao Zhu","doi":"10.1097/JU.0000000000004545","DOIUrl":"10.1097/JU.0000000000004545","url":null,"abstract":"<p><strong>Purpose: </strong>The European Association of Urology guidelines and the latest recommendations from the US Prostate Cancer Conference suggest a castration threshold of 20 ng/dL. However, the current National Comprehensive Cancer Network and AUA guidelines still recommend a castration standard of 50 ng/dL. It remains unknown whether there is a relationship between maintaining lower testosterone levels and the prognosis of patients with nonmetastatic castration-resistant prostate cancer (nmCRPC).</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis based on 2 phase 3 clinical trials (SPARTAN-NCT01946204, ARAMIS-NCT02200614). Patients receiving the currently recommended first-line treatment regimens (androgen deprivation therapy + apalutamide in SPARTAN and androgen deprivation therapy + darolutamide in ARAMIS) were classified into 2 groups according to their maintenance levels of serum testosterone during treatment: below 20 ng/dL and above 20 ng/dL. The study end point was metastasis-free survival (MFS). Inverse probability of treatment weighting method was used to balance patients' baseline characteristics. Kaplan-Meier analysis, multivariable Cox regression models, and Cox models that included testosterone levels as a time-dependent covariate were used to investigate the influence of maintenance levels of serum testosterone on MFS.</p><p><strong>Results: </strong>Baseline characteristics were well balanced between the low testosterone group and the high testosterone group after applying inverse probability of treatment weighting weights. Kaplan-Meier analysis indicated that there was no statistically significant association between serum testosterone levels and MFS in either trial. In both multivariable Cox regression models and time-dependent Cox regression models, the relationship between serum testosterone levels and MFS did not show statistical significance either, using below 20 ng/dL as the reference group (multivariable Cox: SPARTAN HR, 0.68 [95% CI, 0.47-0.98; <i>P</i> < .05], ARAMIS HR, 0.83 [95% CI, 0.57-1.20; <i>P</i> = .320]; time-dependent Cox: SPARTAN HR, 0.84 [95% CI, 0.68-1.04; <i>P</i> = .110], ARAMIS HR, 1.21 [95% CI, 0.71-2.08; <i>P</i> = .480]). The results obtained by setting testosterone levels as a continuous variable were similar.</p><p><strong>Conclusions: </strong>Among all men with testosterone < 50 ng/dL, maintenance serum testosterone levels ≥ 20 ng/dL were not associated with poorer MFS in the first-line therapy of nmCRPC with novel hormonal agents. The prognostic value of maintaining testosterone levels < 20 ng/dL in patients with nmCRPC is limited, and further treatment intensification is not indicated.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT01946204, NCT02200614.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"10-17"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitated Clearance of Small, Asymptomatic Renal Stones With Burst Wave Lithotripsy and Ultrasonic Propulsion.","authors":"Jonathan D Harper, Barbrina Dunmire, Jeff Thiel, Barbara H Burke, Yak-Nam Wang, Stephanie Totten, John C Kucewicz, Adam D Maxwell, M Kennedy Hall, Arturo E Holmes, Christina Popchoi, James E Lingeman, Alana C Desai, Robert M Sweet, Manjiri Dighe, Branda J Levchak, Claire C Yang, Michael R Bailey, Mathew D Sorensen","doi":"10.1097/JU.0000000000004533","DOIUrl":"10.1097/JU.0000000000004533","url":null,"abstract":"<p><strong>Purpose: </strong>We tested feasibility of burst wave lithotripsy and ultrasonic propulsion to noninvasively fragment and expel small, asymptomatic renal stones in awake participants.</p><p><strong>Materials and methods: </strong>Adult patients suspected of having 2- to 7-mm stones were consented and screened for eligibility. Burst wave lithotripsy and ultrasonic propulsion were applied to up to 3 stones in 1 kidney of qualifying participants for a 30-minute total exposure. Participants completed a CT scan and the Wisconsin Stone Quality-of-Life (WISQOL) questionnaire within 90 days before and 120 days after the procedure. Participants were contacted weekly for 3 weeks after the procedure to assess adverse events (AEs). Outcomes included (1) no fragment > 2 mm, (2) unanticipated health care visits, (3) change in stone volume, (4) reported AEs, and (5) WISQOL score.</p><p><strong>Results: </strong>Forty-one participants were enrolled between April 2023 and October 2024. Twenty-one participants failed screening because no stones were seen, stones were too large or small, stone visibility was too deep or obstructed, or they declined to participate. Twenty participants with 31 stones received the research procedure with 7 undergoing a single repeat procedure. Twenty-two of 31 stones (71%) met the primary effectiveness outcome of no fragment > 2 mm, with 17 of 31 stones (55%) reported as stone free. Median stone volume reduction (IQR) was 100% (88%-100%). No participants returned unexpectedly for care related to the procedure. AEs were all grade I by modified Clavien classification. WISQOL scores improved on 10 of 15 completed questionnaires.</p><p><strong>Conclusions: </strong>Small, asymptomatic renal stones were effectively and safely removed in awake participants in a clinic setting.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"41-47"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Functional Urinary Incontinence and School Performance: A Nationwide Matched Cohort Study.","authors":"Britt Borg, Betina B Trabjerg, Julie Werenberg Dreier, Søren Rittig, Anders Breinbjerg, Jakob Christensen, Kristian Juul, Per Hove Thomsen, Konstantinos Kamperis","doi":"10.1097/JU.0000000000004532","DOIUrl":"10.1097/JU.0000000000004532","url":null,"abstract":"<p><strong>Purpose: </strong>Childhood urinary incontinence (UI) is a common disorder with significant negative impact on self-esteem and quality of life, but the impact on school performance is unknown. This study investigates how UI in children is associated with school performance.</p><p><strong>Materials and methods: </strong>This is a nationwide matched cohort study of children born in Denmark to Danish parents between 1997 and 2008 investigating association between UI and results from standardized National School Tests from 2010 to 2018 (1- to 100-point scale). Multiple linear regression estimated difference (∆) in test scores between children with UI and matched references after adjusting for relevant confounders. Subanalyses investigated the influence of psychiatric disorders (PDs) and age at treatment onset.</p><p><strong>Results: </strong>Overall, children with UI (n = 42,999) performed comparably with the matched reference children (n = 429,999; ∆ range -2.5 to +0.6 points). Children with UI co-occurring with PDs scored substantially lower than the reference population, most pronounced for attention-deficit/hyperactivity disorder (∆ range -3.7 to -11.2 points). Children with nocturnal enuresis aged 11 years and older at treatment onset had lower overall school performance than children aged 5 to 7 years at treatment onset (∆ -2.9 [95% CI, -4.0 to -1.7]).</p><p><strong>Conclusions: </strong>School performance in children with UI was normal. However, because PDs are more prevalent in UI and children with UI and co-occurring PDs had significantly lower school performance, we recommend assessing for PDs in UI. Children with late treatment onset had lower school performance than children with early treatment onset; further research is needed on the effect of delayed treatment on children with UI.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"58-68"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Andrew Rosenzweig, Charles Welliver","doi":"10.1097/JU.0000000000004536","DOIUrl":"10.1097/JU.0000000000004536","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"56"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}