Research and Reports in Urology最新文献

{"title":"Metastatic Prostate Cancer: Impact of Site on Oncological Outcomes in Japanese Patients.","authors":"Kentaro Arinami, Keita Tsuboya, Kozue Ito, Shuhei Kondo, Yurie Takizawa, Yohei Ikeda, Gen Kawaguchi, Noboru Hara, Tsutomu Nishiyama","doi":"10.2147/RRU.S625215","DOIUrl":"10.2147/RRU.S625215","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the site of metastasis and progression to castration-resistant prostate cancer (CRPC) following treatment of patients with metastatic prostate cancer who were diagnosed and treated at our hospital.</p><p><strong>Methods: </strong>We retrospectively examined the metastasis status and treatment response of patients with metastatic prostate cancer who were histologically diagnosed between the opening of our hospital in June 2015 and March 2025.</p><p><strong>Results: </strong>A total of 139 patients with metastatic prostate cancer visited our hospital and were diagnosed with the condition. CRPC-free survival was significantly correlated with the bone metastasis volume (EOD 0 and 1 vs EOD 2 to 4) (P = 0.0000477), volume categories (P = 0.00196), risk categories (P = 0.00231), and PSA levels below/not below 0.2 ng/mL following ADT (P = 4.18 × 10^-16); however, it was not significantly correlated with the biopsy Gleason grade group (GG) (GG5 vs GG<5) (P = 0.324) or lung metastasis (P = 0.894). None of the eight patients with lung metastases who were without bone metastases progressed to CRPC during the observation period following androgen deprivation therapy (ADT). There was a significant difference in CRPC-free survival between patients with lung metastasis but without bone metastasis (sample size: 8) and those with other metastasis sites but without lung metastasis (sample size: 131) (P = 0.025).</p><p><strong>Discussion and conclusion: </strong>In our data on patients with metastatic prostate cancer, factors influencing the prognosis were: the extent of bone metastasis and responsiveness of PSA levels to initial treatments such as ADT. Factors such as GG at the time of biopsy or presence of lung metastases did not significantly impact the prognosis. Our data suggest that patients with lung metastases, but without bone metastases, may have a relatively favorable prognosis. New prognostic evaluation indicators are needed.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"625215"},"PeriodicalIF":2.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Detection without Clinical Benefit: A Prospective Comparison of CT and Ultrasonography After Stone Surgery.","authors":"Mahmoud Abbas, Alaa Alden-Natsheh, Mohammad Abu-Ahmad, Michael Pashrsnik, Boris Chertin, Ilan Kafka","doi":"10.2147/RRU.S619885","DOIUrl":"10.2147/RRU.S619885","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the superior diagnostic accuracy of non-contrast computed tomography (NCCT) translates into clinically meaningful changes in management compared with ultrasonography (US) during routine postoperative follow-up after endourological stone surgery.</p><p><strong>Patients and methods: </strong>In this prospective observational study (n=60), adult patients undergoing ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL) were assessed at 4-6 weeks postoperatively using both US and NCCT within ≤72 hours. NCCT served as the reference standard. The primary outcome was the diagnostic performance of US. The secondary outcome was the proportion of cases in which NCCT findings led to a change in clinical management. Multivariable logistic regression was used to identify predictors of false-positive US findings.</p><p><strong>Results: </strong>Sixty patients were included (mean age 52.3 ± 18.6 years; mean BMI 26.2 ± 6.8 kg/m²). NCCT identified residual stones in 14 patients (23.4%), totaling 27 stones. On stone-based analysis, US demonstrated a sensitivity of 79% (95% CI 69-86%) and a positive predictive value of 75%. NCCT detected additional findings not visualized on US in 6 patients (10%), all of which were small (≤4 mm) and non-obstructive. Importantly, NCCT findings resulted in clinically meaningful changes in management in only 2 of 60 patients (3.3%), despite its higher diagnostic sensitivity. US demonstrated a tendency to overestimate stone size, particularly with increasing BMI, which was the only significant predictor of false-positive findings (OR 1.12 per kg/m², p = 0.008).</p><p><strong>Conclusion: </strong>Although NCCT demonstrates superior diagnostic accuracy, it rarely results in clinically meaningful changes in management in routine postoperative follow-up after endourological stone surgery. Ultrasonography provides acceptable diagnostic performance for clinically relevant stones. These findings support a risk-adapted imaging strategy in which ultrasonography serves as first-line surveillance, reserving CT for cases where results are expected to influence management.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"619885"},"PeriodicalIF":2.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of the PROMOD Strategy, Combining PI-RADS Score and PSA Density, to Select Patients for Prostatic Biopsies.","authors":"Clémentine Le Méner, Emmanuel Nowak, Alexandre Fourcade, Valentin Tissot, Audrey Zambon, Claire Siebert, Joséphine Renand, Laurent Doucet, Arnaud Uguen, Georges Fournier, Antoine Valeri","doi":"10.2147/RRU.S612881","DOIUrl":"10.2147/RRU.S612881","url":null,"abstract":"<p><strong>Purpose: </strong>Combining MRI PI-RADS score (Prostate Imaging Reporting and Data System) with prostate-specific antigen density (PSAd) may optimize prostate biopsy (PBx) decisions. We aimed to externally validate the PROMOD strategy, combining PI-RADS with PSAd.</p><p><strong>Patients and methods: </strong>We retrospectively included 972 men who underwent PBx, i.e. 12-core systematic, 2-4 targeted (MRI-FUSION) between 2013 and 2022, recorded in a prospectively maintained database. Patients with PSA > 20 ng/mL or prior prostate cancer (PCa) were excluded. We evaluated rates of avoided PBx, missed low-grade cancers, and csPCa (ISUP grade ≥2) according to 10 strategies. Decision curve analysis (DCA) assessed net benefit.</p><p><strong>Results: </strong>According to DCA, the highest net benefit in biopsy-naïve men was obtained by Strategies 8 (PI-RADS 4-5 or PI-RADS 3 with PSAd >0.15 ng/mL²) and 7 (PI-RADS 4-5 or PI-RADS 3 with PSAd >0.20 ng/mL²) reducing biopsies by 18-20% (95% CIs 15.5-21.2 and 16.9-22.7), missing 5-8% csPCa (95% CIs 3.8-8.4 and 4.9-10.0). Strategy 10 (PI-RADS 4-5 or PI-RADS 3 with PSAd >0.10 ng/mL² or PSAd >0.20 ng/mL²) was more conservative, avoiding 12% PBx (95% CI 9.7-14.5) and 2% missed csPCa (95% CI 0.9-3.8). Similar patterns were observed in the previous negative biopsy group.</p><p><strong>Conclusion: </strong>The PROMOD Strategy is an effective tool allowing a tailored decision to perform PBx based on degrees of risk that both patients and clinicians are willing to accept, in the context of shared decision-making.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"612881"},"PeriodicalIF":2.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Analysis of Testicular Cancer (2007-2025): A Single Institutional Experience.","authors":"Hamza Abedallaa, Zuheir Al-Shehabi, Nader Abedallaa","doi":"10.2147/RRU.S623531","DOIUrl":"10.2147/RRU.S623531","url":null,"abstract":"<p><strong>Background: </strong>Testicular cancer (TC) is the leading cancer among adolescents and young adults (AYAs) aged 15-39 years and one of the most curable cancers.</p><p><strong>Objective: </strong>The study aims to assess epidemiology, histological classification, stage at diagnosis, prognosis, stage I risk assessment and relationship between prognosis and age in the Center of Chemotherapy and Radiotherapy at Latakia University Hospital.</p><p><strong>Methods: </strong>318 patients with testicular cancer who had been attended to the Chemotherapy and Radiotherapy Center at Latakia University Hospital from its opening in 2007 until October 2025 were included in this retrospective analysis.</p><p><strong>Results: </strong>The median age at diagnosis was 32 years. The most prevalent testicular cancer (TC) was germ cell type. Among germ cell tumors, non-seminomatous types (51.6%) were slightly more frequent than seminomatous (45.9%). The most frequent non-seminomatous subtype was: mixed germ cell tumors (29.9%). The majority of TC patients were in stage I. About two-thirds of the seminoma patients were in stage I, while it represented about half of the non-seminoma patients with a significant difference between the two types. Two (2.86%) patients with vascular invasion, 31 (44.29%) with embryonal carcinoma, both vascular invasion and embryonal carcinoma in 8 (11.43%), and no risk factors were detected in 29 (41.43%) patients in non-seminoma. In seminoma, 40 (41.24%) patients reviewed with tumor size >4cm, 5 (5.15%) with rete testis invasion, 19 (19.59%) with both, and no risk factors were detected in 33 (34.02%) patients. No significant difference in the age of patients was shown after categorizing them according to their prognosis.</p><p><strong>Conclusion: </strong>The findings align with global proportions and can support those interested in the field in reducing disease burden, but further research is needed, especially in Syria and the Middle East due to limited studies.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"623531"},"PeriodicalIF":2.4,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystinuria: Diagnosis, Medical and Surgical Management, and Emerging Therapies. A Narrative Review.","authors":"Alberto Zambudio Munuera, Patricia Rodriguez Parras, Juan Antonio Galan Llopis, Feliciano Grases Freixedas, Maria Del Carmen Cano Garcia, Miguel Arrabal-Martin, Miguel Angel Arrabal Polo","doi":"10.2147/RRU.S629402","DOIUrl":"10.2147/RRU.S629402","url":null,"abstract":"<p><p>Cystinuria is a hereditary aminoaciduria causing recurrent cystine nephrolithiasis, impaired quality of life and potential renal function decline. Despite established treatment guidelines, real-world data reveal a persistent gap between recommended targets and clinical outcomes. Preliminary data from the EUROCYS 2024 prospective European registry (269 patients, 29 centers, 8 countries) showed that only 16.3% of patients achieved the target urinary pH range, 55.2% remained above the conventional urinary cystine threshold of 250 mg/L, and approximately 39% experienced a new stone event within the preceding 12 months, despite follow-up in specialist centers. Discontinuation rates for available thiol drugs have been reported to reach 30-50%. This narrative review, based on a structured non-systematic search of major databases and guideline repositories (2009-2026), synthesizes current evidence on cystinuria diagnosis and management and appraises emerging adjunctive interventions. Next-generation sequencing-based genetic testing and the cystine capacity assay represent key recent advances in monitoring. Thulium fiber laser lithotripsy and miniaturized percutaneous approaches offer less traumatic surgical options in this high-burden population. Oral N-acetylcysteine has mechanistic plausibility and a favorable, well-characterized safety profile in other clinical settings, making it a rational candidate for formal prospective evaluation; however, robust clinical trial evidence in cystinuria using contemporary monitoring parameters is lacking. Current standard treatment remains insufficient for a substantial proportion of patients, underscoring the need to evaluate accessible adjunctive therapies with defined mechanisms and measurable outcomes.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"629402"},"PeriodicalIF":2.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fucoidan from <i>Undaria pinnatifida</i> Improves Benign Prostatic Hyperplasia Symptoms in Men: A Randomized, Double-Blind, Placebo-Controlled Study.","authors":"Barbara Caecilia Wimmer, Corinna Anne Dwan, Sagar Sudhir Bhalerao, Chirag Govind Gupta, Sanjay Vishnu Vaze, Shalaka Sharad Kshirsagar","doi":"10.2147/RRU.S597883","DOIUrl":"10.2147/RRU.S597883","url":null,"abstract":"<p><strong>Purpose: </strong>Benign Prostatic Hyperplasia (BPH) is a common non-malignant prostate enlargement that contributes to bladder outlet obstruction and lower urinary tract symptoms in men as they age.</p><p><strong>Patients and methods: </strong>In this 90-day study, ninety-five men aged 45-80 years with clinically and radiologically confirmed moderate BPH [International Prostate Symptom Score (IPSS) between 8-19] were randomly allocated (1:1) to receive either <i>Undaria pinnatifida</i> fucoidan (UPF) or placebo. Prostate health was evaluated using the validated IPSS (total and composite sub-scores) on days 30, 60 and 90. Potential clinically meaningful IPSS reductions were assessed as Minimum Clinically Important Difference (MCID). Urinary flow rate, post-void residual volume (PVR) and prostate-specific antigen were also assessed.</p><p><strong>Results: </strong>By day 60, the UPF group showed significant improvement in total IPSS score compared to placebo (p=0.0234), with further improvements by day 90 (p=0.0015). The mean reduction in total IPSS score from baseline to day 90 was -3.40 in the UPF group versus -0.93 in the placebo group. Voiding (p=0.0006) and storage (p=0.0150), sub-scores improved significantly by day 90 in the UPF group. Quality of life related to urinary symptoms improved continuously by day 60 and 90 (both p<0.05 vs placebo). A higher proportion of UPF-treated participants achieved MCID ≥2 (60.0%) and ≥3 points (51.1%) compared to placebo (42.2% and 28.9%), with statistical significance for ≥3 points (p=0.0314) at day 90. Urinary flow rate improved and PVR decreased in both groups; however, between-group differences, including PSA, were not statistically significant. Importantly, UPF was well tolerated.</p><p><strong>Conclusion: </strong>UPF supplementation was associated with statistically and clinically significant IPSS improvement, including voiding and storage composite scores, and enhanced prostate-related quality of life when compared to placebo. Secondary outcomes did not differ significantly between groups, and the duration (90 days) limits long-term interpretation. UPF appears safe and potentially beneficial for managing moderate BPH symptoms.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"597883"},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Multimodal MRI Diffusion and Multiphase CT Parameters for Estimating Glomerular Filtration Rate in Patients with Acute Renal Obstruction.","authors":"Thi Song Huong Tran, Hong Phuong Dung Tran, Ngoc Thanh Hoang, Hoang Minh Hieu Nguyen, Khoa Hung Nguyen, Trong Binh Le, Dac Hong An Ngo, Thanh Thao Nguyen","doi":"10.2147/RRU.S615945","DOIUrl":"10.2147/RRU.S615945","url":null,"abstract":"<p><strong>Objective: </strong>This exploratory study aims to develop a multimodal model predicting estimated glomerular filtration rate (eGFR) by integrating functional Magnetic Resonance Imaging (MRI) diffusion metrics and multiphase Computed Tomography (CT) hemodynamic indices in acute urinary obstruction.</p><p><strong>Methods: </strong>Thirty-five patients with acute urinary obstruction underwent multiphase CT and Diffusion-Weighted Imaging (DWI). We measured DWI-based indices-including Apparent Diffusion Coefficient (ADC), Slow Diffusion Coefficient (SDC), and normalized ratios-alongside CT-derived metrics, specifically Difference of Renal Attenuation (DRA), Corticomedullary Differentiation (CMD), and Difference in Corticomedullary Differentiation (DCMD). These indices were compared between obstructed and contralateral (normal) kidneys to assess diagnostic value Predictive models for eGFR were developed using various index combinations, selecting the optimal model based on the highest Adjusted R-squared (R²). Model accuracy was validated using Mean Absolute Error (MAE) and Root Mean Square Error (RMSE), with age and sex as fixed covariates (p<0.05).</p><p><strong>Results: </strong>Obstructed kidneys exhibited significantly lower native CT density (32.5 ± 4.2 vs 34.3 ± 2.6 HU, p= 0.011) and reduced CMD (p< 0.001) than normal kidneys. Although ADC and ADC ratios showed no significant differences (p> 0.05), the SDC and SDC ratios (rSDC) were significantly higher in obstructed kidneys (SDC: 0.14 ± 0.03 vs 0.13 ± 0.03; rSDC_Muscle: 7.05 ± 2.69 vs 6.18 ± 2.34; rSDC_Spleen: 1.70 vs 1.47; all p< 0.05). Combining diffusion metrics with multiphase CT attenuation enhanced eGFR prediction. The best model, integrating ADC, CMD, and Mean_rADC_Muscle, achieved an adjusted R²= 0.433 (p= 0.0005). The similar MAE (0.552) and RMSE (0.695) values demonstrate consistent eGFR estimation with minimal variability.</p><p><strong>Conclusion: </strong>This exploratory investigation highlights the potential of a multimodal framework that integrates CT hemodynamic indices with MRI microstructural metrics for noninvasive eGFR estimation in acute urinary obstruction. This quantitative methodology demonstrates promising capability in identifying localized renal impairment, serving to complement established laboratory diagnostics.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"615945"},"PeriodicalIF":2.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage of a Penetrating Bilateral Testicular Gunshot Injury Using an Autologous Free Tunica Albuginea Graft from the Excised Contralateral Testis: A Case Report.","authors":"Anas Saad, Omar Al-Abed, Salem Hakouk, Mohammad Alaa Aldakak","doi":"10.2147/RRU.S627689","DOIUrl":"10.2147/RRU.S627689","url":null,"abstract":"<p><strong>Background: </strong>Penetrating scrotal trauma is an uncommon but potentially devastating urogenital injury. Testicular rupture requires prompt exploration, particularly when associated with urethral or corporal trauma. When primary closure of the tunica albuginea is not feasible, reconstructive alternatives may be needed to preserve viable testicular tissue.</p><p><strong>Case presentation: </strong>We report an 18-year-old male who sustained a ricocheting gunshot injury to the perineum and external genitalia. After initial cystostomy and wound packing at a non-specialized hospital, he was referred to our center approximately 12 hours after injury. Exploration revealed complete destruction of the right testis, severe rupture of the left testis with extrusion of seminiferous tubules and a large tunica albuginea defect, a partial distal bulbar urethral laceration, and a 1-cm laceration of the left corpus cavernosum. The right testis was unsalvageable and excised. The urethral and corporal injuries were repaired primarily. Because the left testis could not be closed primarily and the tunica vaginalis was inadequate, an autologous free graft harvested from the tunica albuginea of the excised right testis was used to close the defect.</p><p><strong>Discussion: </strong>Previously described options for large tunica albuginea defects include tunica vaginalis-based techniques and biologic or synthetic grafts. Our approach used contralateral tunica albuginea as an immediately available autologous graft.</p><p><strong>Conclusion: </strong>At 3-month follow-up, the patient had preserved testicular vascularity and volume, normal voiding and erections, and reference-range testosterone. However, persistent severe oligozoospermia and elevated gonadotropins indicated impaired spermatogenesis, prompting fertility counseling and repeat sperm cryopreservation. This technique may represent a feasible testis-sparing option in carefully selected cases.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"627689"},"PeriodicalIF":2.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Robosling Technique in Robotic Radical Prostatectomy Promotes Early and Sustained Return of Continence in Elderly Patients.","authors":"Victor Yu, Damien Gibson, Juliette Cotte, Amer Amin, Lewis Chan, Nariman Ahmadi, Nicola Jeffery, Ruban Thanigasalam, Scott Leslie","doi":"10.2147/RRU.S599921","DOIUrl":"10.2147/RRU.S599921","url":null,"abstract":"<p><strong>Aim: </strong>The Robosling technique is a novel autologous fascial sling which supports the urethrovesical anastomosis in robotic radical prostatectomy (RARP) and has shown promise in improving early continence. Although curative surgery for prostate cancer is uncommonly offered to elderly patients aged ≥75, increase in active surveillance and overall life expectancy challenges this paradigm, though continence remains a challenge in this cohort. We sought to investigate the role of the Robosling technique in elderly patients to promote early return of continence.</p><p><strong>Methods: </strong>Our prospective RARP database (2016-2023) was analysed, recording demographic, surgical, pathological and functional outcomes. The primary endpoint was defined as pad-free continence, 1-year post-operatively. Patients aged ≥75 undergoing RARP with or without Robosling were compared using Chi-square/Fisher-exact and <i>t</i>-tests with <i>p</i><0.05 considered significant. Multinomial logistic regression was performed to account for confounders.</p><p><strong>Results: </strong>62 patients were included in the analysis (Robosling n=24). No significant differences were detected in surgical or pathological outcomes. Robosling was associated with improved pad-free continence rates from 6-months post-operatively (62.5% vs 30.0%, <i>p</i>=0.018) and sustained at 1-year (79.2% vs 30.0%, <i>p</i><0.01). Mean pad-use was lower in the Robosling cohort at all time points (0.21 vs 1.0 pads at 1-year, <i>p</i><0.05). On multivariate analysis, Robosling remained independently associated with improved pad-free continence (OR 0.11, 95% CI 0.03-0.37, p<0.001).</p><p><strong>Conclusion: </strong>The Robosling technique is associated with significantly improved early and sustained pad-free continence rates in the elderly population in this single-surgeon study. While patient selection remains paramount, this intraoperative technique may mitigate a key quality-of-life concern in this cohort.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"599921"},"PeriodicalIF":2.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal Reference Values for Testicular Volume in Adult Somali Men: A Retrospective Study.","authors":"Khalid Abdukadir Osman, Abdulfatah Hassan Maqul, Abdullahi Abdi Farah, Abdirahman Omar Sahal, Walid Abdulkadir Osman","doi":"10.2147/RRU.S615746","DOIUrl":"10.2147/RRU.S615746","url":null,"abstract":"<p><strong>Background: </strong>Testicular volume is a critical marker of male reproductive and endocrine health; however, reference values are population-specific. In the absence of ultrasound-based normative data for Somali men, clinicians often rely on external benchmarks that may lead to the misdiagnosis of normal variants. This study aimed to establish ultrasound-derived reference intervals, determine the Minimal Detectable Difference (MDD) for asymmetry, and develop a prediction equation for contralateral volume in Adult Somali men.</p><p><strong>Methods: </strong>This retrospective study analyzed 212 sonographically normal Somali men (ages 18-84) at Sahan Diagnostic Center in Mogadishu, Somalia, from June 2022 to December 2025. Volumes were calculated using the standard ellipsoid formula. Statistical analyses included percentile-based reference intervals (2.5^th-97.5^th), Cohen's d for cross-population comparisons, and linear regression to derive a contralateral prediction equation.</p><p><strong>Results: </strong>Mean testicular volumes were 10.61±3.07 mL (right) and 10.19±3.02 mL (left), with a median of 10.0 mL for both. The 95% reference intervals were 5.7-18.0 mL (right) and 5.2-17.0 mL (left). The right testis was significantly larger than the left (p < 0.001), and no significant correlation with age was observed. The MDD for asymmetry was 4.1 mL. Notable differences were found compared to European (d = 1.90), West African (d = 1.88), and East and Southeast Asian (d = 0.76-2.01) cohorts.</p><p><strong>Conclusion: </strong>These findings establish the first Somali-specific ultrasound benchmarks. Incorporating these intervals and the 4.1 mL MDD into clinical practice will improve diagnostic accuracy in andrological assessments and prevent the misapplication of non-representative global norms.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"615746"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}