Research and Reports in Urology最新文献

{"title":"Vacuum-Assisted Mini-PCNL is Associated with Lower Postoperative SIRS: A Real-World Cohort Study.","authors":"Surawach Piyawannarat, Kun Sirisopana, Nipapan Choonu, Yada Phengsalae, Premsant Sangkum, Chinnakhet Ketsuwan, Wisoot Kongchareonsombat","doi":"10.2147/RRU.S618289","DOIUrl":"10.2147/RRU.S618289","url":null,"abstract":"<p><strong>Background: </strong>Postoperative systemic inflammatory response syndrome (SIRS) remains a key complication after mini-percutaneous nephrolithotomy (mini-PCNL) and is often related to elevated intrarenal pressure and bacterial translocation. Vacuum-assisted mini-PCNL (VmPCNL) has been developed to mitigate this risk through active pressure control.</p><p><strong>Objective: </strong>To evaluate the association between VmPCNL and postoperative SIRS and to identify the independent predictors of SIRS in a real-world cohort.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted of patients undergoing mini-PCNL at a tertiary referral center between January 2021 and May 2025. Patients were stratified into standard mini-PCNL (SmPCNL) and VmPCNL groups. The primary endpoint was SIRS within 48 hours post-surgery. Secondary outcomes included operative time, stone-free rate (SFR), and length of hospital stay (LOS). Multivariable logistic regression was used to identify independent predictors of SIRS.</p><p><strong>Results: </strong>A total of 136 patients were included in the study (SmPCNL, n = 78; VmPCNL, n = 58). The incidence of postoperative SIRS was significantly lower in the VmPCNL group (8.6% vs 21.8%, p = 0.036). VmPCNL was also associated with shorter operative time (median 90 minutes vs 115 minutes, p = 0.038) and reduced LOS (p = 0.012). Stone-free rates were comparable between the groups, indicating no compromise in procedural efficacy. In the multivariable analysis, VmPCNL was independently associated with a lower risk of SIRS (adjusted OR [aOR] 0.44, 95% CI 0.19-0.98, p = 0.041), while a positive preoperative urine culture was an independent risk factor (aOR 2.60, 95% CI 1.01-6.60, p = 0.045).</p><p><strong>Conclusion: </strong>In this real-world cohort, VmPCNL was associated with a lower SIRS incidence and improved perioperative efficiency without compromising stone-free outcomes. The mechanism may involve improved intraoperative outflow dynamics through active suction, although direct measurement of intrarenal pressure is needed to confirm this hypothesis.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"618289"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295732","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":"Assessing the Knowledge and Awareness of Urinary Incontinence Among Urogynecology Clinic Patients in Jordan: A Cross-Sectional Study.","authors":"Mohammad Abufaraj, Dina Mohammed, Hamza Al-Amoosh, Rami Mohammed Shwyiat, Tina Sami Alkhoury, Aysheh Alamoush, Samia Sulaiman, Akram Kilani, Dana Ayman Alqatawneh, Diala Tareq Abu AlHaija, Omar Haddadin","doi":"10.2147/RRU.S607618","DOIUrl":"10.2147/RRU.S607618","url":null,"abstract":"<p><strong>Objective: </strong>To assess knowledge and awareness of urinary incontinence (UI) among Jordanian women attending a urogynecology clinic and identify sociodemographic and clinical factors associated with knowledge levels.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 294 women aged 18 to 80 years who attended the urogynecology clinic at King Hussein Medical Center (KHMC) in Amman, Jordan, from February 2022 to April 2023. Knowledge was measured using the validated Prolapse and Incontinence Knowledge Questionnaire (PIKQ) through structured interviews. Each correct answer was awarded one point, while incorrect or \"do not know\" responses were scored as zero. Total scores, ranging from 0 to 12, were converted to percentages. Data normality was assessed using the Shapiro-Wilk and Kolmogorov-Smirnov tests. Associations between knowledge scores and sociodemographic or clinical variables were examined using Spearman's rank correlation coefficient. Statistical analyses were performed with IBM SPSS version 28.0, and statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The mean knowledge score was 8.77 ± 1.39 out of 12 (73.06%). Higher knowledge scores were significantly associated with greater educational level, higher income, employment in healthcare, and previous treatment for UI (p<0.05). In contrast, increasing age, higher number of children, and postmenopausal status were significantly associated with lower knowledge scores (p<0.05). No significant associations were found between knowledge scores and marital status, prior consultation with a urologist or urogynecologist, or personal history of UI.</p><p><strong>Conclusion: </strong>Women attending a urogynecology clinic in Jordan demonstrated moderate overall knowledge of UI. However, substantial knowledge gaps remain, particularly concerning treatment options and disease management. These results underscore the need for targeted educational interventions, particularly for older, multiparous, and postmenopausal women, to improve understanding, address misconceptions, and enhance clinical outcomes and quality of life.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"607618"},"PeriodicalIF":2.4,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272242","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":"Early Progressive Disease During Nivolumab Plus Ipilimumab Therapy Predicts Poor Survival in Japanese Patients with Advanced Renal Cell Carcinoma: A Single-Center 12-Week Landmark Study.","authors":"Nobuki Furubayashi, Jiro Tsujita, Azusa Takayama, Yuta Shiraishi, Motonobu Nakamura, Takahito Negishi","doi":"10.2147/RRU.S612372","DOIUrl":"10.2147/RRU.S612372","url":null,"abstract":"<p><strong>Background: </strong>It is clinically important to identify early progressive disease (PD) during nivolumab plus ipilimumab therapy for advanced renal cell carcinoma (RCC). However, the predictors of early PD are unclarified. We evaluated the prognostic impact and baseline predictors of early PD.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed consecutive patients with advanced RCC who received nivolumab plus ipilimumab at Kyushu Cancer Center between September 2018 and January 2026. Tumor response was assessed using the RECIST version 1.1 guidelines. Early PD was defined as PD within 12 weeks from treatment initiation or PD at the first radiologic assessment. Overall survival (OS) was evaluated at the 12-week landmark. Cox regression was used to identify prognostic factors for landmark OS, and logistic regression was used to explore predictors of early PD.</p><p><strong>Results: </strong>The 12-week landmark cohort comprised 38 patients (early PD, n=14; non-early PD, n=24). Landmark OS was significantly shorter in the early PD group than in the non-early PD group (median, 12.9 vs. 66.1 months; log-rank P<0.001). In multivariable Cox regression, early PD (hazard ratio 3.67; 95% confidence interval 1.28-10.59; P=0.016) and International Metastatic RCC Database Consortium (IMDC) poor risk (hazard ratio 3.16; 95% confidence interval 1.24-8.07; P=0.016) were independently associated with worse OS. In exploratory multivariable logistic regression, non-clear cell histology was significantly associated with early PD (odds ratio 9.01; 95% confidence interval 1.45-56.20; P=0.019).</p><p><strong>Conclusion: </strong>Early PD during nivolumab plus ipilimumab identifies a high-risk population with markedly inferior survival. Non-clear cell histology was significantly associated with early PD in exploratory multivariable analysis and may help guide individualized first-line treatment selection and patient counseling in advanced RCC.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"612372"},"PeriodicalIF":2.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227301","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":"Hydrocelectomy Complication Rates in the United States.","authors":"Dennis J Head, Jay D Raman, Roderick K Clark","doi":"10.2147/RRU.S601188","DOIUrl":"10.2147/RRU.S601188","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Hydrocelectomy is the gold standard treatment for hydrocele. European data showed complication rates between 16% and 25%, however the rate within the United States has not been assessed. We examined the postoperative complication, emergency department visit, readmission and re-operation rates after hydrocelectomy in the United States.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 27,418 individuals who underwent hydrocelectomy in the United States between 2004 and 2024 identified through the TriNetX US Network using ICD-10 and CPT codes. Patients were excluded for age <18 years, testicular neoplasm, and orchiectomy. The primary outcome was rate of any surgical complication, emergency department (ED) visit, readmission, or reoperation within 90 days of hydrocelectomy. Statistical analysis was performed with R software and using t-tests.</p><p><strong>Results: </strong>The mean age of our cohort was 51 years. The complication group had higher proportions of older (p < 0.001), African American (p < 0.001), and patients with hypertension, diabetes, and coagulation defects (p < 0.001).The risk of complications was 13% within 90 days of surgery. The ED visit rate was 6.7%, surgical complication rate of 5.6%, readmission rate of 2.6%, and reoperation rate of 2.6%. Of surgical complications, 25% were bleeding, 13% were infection, and 63% were inflammatory or unspecified complications. The median ED visit was day 14 (IQR 6-41) and the median reoperation was at day 21 (IQR 9-38). Patients had a 9.2% rate of overall complications in the first month after surgery, after which the risk decreased.</p><p><strong>Conclusion: </strong>The rate of complications after hydrocelectomy in the United States is 13%, with 9% occurring in the first 30 days. There was a 2.8% risk of surgical intervention within 90 days. We recommend close follow-up in the first month to evaluate for developing complications, especially for patients with hypertension, diabetes, or coagulation defects.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"601188"},"PeriodicalIF":2.4,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205931","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":"Artificial Intelligence as a Diagnostic Tool for Benign Prostatic Hyperplasia (BPH): A Narrative Review.","authors":"Ebraheam Aljazei","doi":"10.2147/RRU.S590693","DOIUrl":"10.2147/RRU.S590693","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a highly prevalent condition among aging men and represents a significant clinical and economic burden. Current diagnostic approaches, including prostate-specific antigen (PSA) testing and imaging modalities, remain limited by low specificity, false-positive findings, and variability in interpretation, particularly in differentiating BPH from prostate cancer.</p><p><strong>Objective: </strong>This narrative review aims to evaluate the role of artificial intelligence (AI) as a diagnostic tool for BPH, focusing on its performance, clinical applications, and potential to address current diagnostic limitations.</p><p><strong>Methods: </strong>A narrative review was conducted using PubMed, Scopus, and ScienceDirect. The search strategy included studies published between 2021 and 2025 using keywords such as (\"benign prostatic hyperplasia\" OR \"BPH\") AND (\"artificial intelligence\" OR \"machine learning\" OR \"deep learning\"). A total of 10 studies meeting predefined inclusion criteria were analyzed, focusing on diagnostic applications of AI in urology.</p><p><strong>Results: </strong>AI-based models demonstrated promising performance across multiple diagnostic domains, including imaging (mpMRI, ultrasound), histopathology, and biomarker-based analysis. Several studies demonstrated improved diagnostic accuracy and reduced interobserver variability compared to conventional methods. AI also showed potential in differentiating BPH from prostate cancer and supporting clinical decision-making. However, significant challenges remain, including heterogeneity of datasets, limited external validation, potential algorithmic bias, and lack of standardized evaluation frameworks.</p><p><strong>Conclusion: </strong>Artificial intelligence represents a promising adjunct in the diagnosis of BPH, with the potential to enhance diagnostic accuracy and optimize clinical workflows. Nevertheless, further high-quality studies, standardized validation, and integration into real-world clinical settings are required before widespread clinical adoption can be achieved.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"590693"},"PeriodicalIF":2.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13228849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157832","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 Added Value of Systematic Biopsy in Biopsy-Naïve Patients Undergoing Magnetic Resonance Imaging-Transrectal Ultrasound Fusion Prostate Biopsy.","authors":"Harutake Sawazaki, Yosuke Kitamura, Atsushi Asano, Sadayoshi Suzuki","doi":"10.2147/RRU.S599974","DOIUrl":"10.2147/RRU.S599974","url":null,"abstract":"<p><strong>Purpose: </strong>The added value of systematic biopsy (SBx) for detection of clinically significant prostate cancer (csPCa) in biopsy-naïve patients undergoing MRI-targeted biopsy (TBx) has been reported. However, the added value of SBx for ISUP upgrading and csPCa localization has not been fully investigated. In this study, we evaluated the added value of SBx in biopsy-naïve patients undergoing MRI-transrectal ultrasound fusion biopsy.</p><p><strong>Patients and methods: </strong>We retrospectively evaluated 220 consecutive biopsy-naïve men with a prebiopsy positive MRI (PIRADS ≥3) and prostate-specific antigen ≤20 ng/mL who underwent MRI-transrectal ultrasound fusion biopsy and systematic 16-core biopsy. Only TBx data for the index lesion (IL) were used when multiple lesions were present on prebiopsy MRI. The csPCa detection rate (International Society of Urological Pathology grade group [ISUP GG] ≥2) was compared between TBx, SBx, and TBx + SBx. The frequency of potentially missed csPCa by TBx alone was determined. GG discrepancies and csPCa localization were compared between TBx and SBx.</p><p><strong>Results: </strong>The overall csPCa detection rate (TBx + SBx) was 54.5% (120/220). The csPCa detection rate was higher for TBx (50.9%, 112/220) than for SBx (45%, 99/220). TBx alone missed csPCa in 8 patients (6.6%, 8/120). SBx led to GG upgrading in 25 (23.5%) of 106 patients who were positive on both TBx and SBx. Of 110 patients with the IL in the peripheral zone (PZ), 76 (69.0%) were diagnosed with csPCa on TBx and 51 (46.3%) had concomitant csPCa in the transition zone (TZ) on SBx. Of 110 patients with the IL in TZ, 36 (32.7%) were diagnosed with csPCa on TBx and 16 (14.5%) had concomitant csPCa in PZ on SBx.</p><p><strong>Conclusion: </strong>SBx had the added value for the detection of csPCa, GG upgrading, and csPCa localization in biopsy-naïve patients undergoing MRI-transrectal ultrasound fusion biopsy.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"599974"},"PeriodicalIF":2.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034516","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":"When Stones Begin: Age of Onset Reveals the Systemic Metabolic Nature of Nephrolithiasis.","authors":"Adel Alrabadi, Baha Aldeen Alshraideh, Ensaf Y Almomani, Yara Alkayed, Mamoun H Abu-Suaileek, Hamza A Alsougier, Shahd A Etoom, Ahmad Qablan, Zaina Alrabadi","doi":"10.2147/RRU.S603165","DOIUrl":"10.2147/RRU.S603165","url":null,"abstract":"<p><strong>Background: </strong>Kidney stone disease is a common urological condition with a rising worldwide incidence. Although multiple metabolic and lifestyle risk factors have been identified, determinants influencing the age at which symptoms begin remain poorly defined. Understanding factors associated with earlier disease presentation may improve prevention strategies.</p><p><strong>Methods: </strong>This observational cohort study included 546 patients with confirmed nephrolithiasis. Participants were stratified into early-onset (<45 years) and late-onset (≥45 years) groups. Sociodemographic, lifestyle, clinical, urinalysis, and biochemical data were collected. Group comparisons were performed using the Chi-square test. Multivariable linear regression analyses evaluated independent associations between age of onset and clinical, laboratory, and hormonal variables. Statistical significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Early-onset disease accounted for 57.1% of cases. Higher body mass index, smoking, functional status, employment, and education level were significantly associated with age of onset (<i>p</i> < 0.001). Several comorbidities, including hypertension, diabetes mellitus, cardiovascular disease, renal impairment, gout, gallstones, and renal cell carcinoma, were inversely associated with age of onset. Regression analyses confirmed younger onset as an independent predictor of hypertension (β = -0.374), diabetes (β = -0.381), heart disease (β = -0.253), renal impairment (β = -0.110), gout (β = -0.120), and gallstones (β = -0.148) (<i>p</i> < 0.05). Urinalysis parameters showed limited associations, with urinary crystals as the only significant predictor (<i>p</i> = 0.012). Elevated serum urea and calcium were independently associated with earlier onsets.</p><p><strong>Conclusion: </strong>Early-onset nephrolithiasis is strongly associated with metabolic and cardiovascular comorbidities and specific biochemical abnormalities. Age of onset may serve as a clinically meaningful marker for risk stratification and targeted preventive interventions.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"603165"},"PeriodicalIF":2.4,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942355","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":"Real-World Predictors of Response to Immunotherapy in Metastatic Renal Cell Carcinoma: The Emerging Role of the Urologist in Immuno-Oncology.","authors":"Celia Abad Rodriguez-Hesles, Francisco Gutierrez-Tejero, Virginia Yuste-Mascarós, Alberto Zambudio-Munuera, Miguel Arrabal-Martin, Miguel Angel Arrabal-Polo","doi":"10.2147/RRU.S594124","DOIUrl":"10.2147/RRU.S594124","url":null,"abstract":"<p><strong>Objective: </strong>Immunotherapy has transformed the treatment of metastatic renal cell carcinoma (mRCC), with urologists playing a central role in systemic treatment selection through multidisciplinary decision-making, patient selection, and treatment sequencing. Identifying predictors of response is essential to personalize therapy and improve outcomes.</p><p><strong>Material and methods: </strong>We conducted a retrospective, single-center study of 32 patients with mRCC who received immunotherapy: 15 received first-line nivolumab-ipilimumab, 3 pembrolizumab-axitinib, 13 second-line nivolumab, and 1 third-line nivolumab. Clinical, histological, and prognostic variables (International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), Meet-URO, FAN score), and blood biomarkers (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil percentage) were assessed using Kaplan-Meier analysis with Log rank tests and Cox regression. Given the small sample size, results should be interpreted with caution.</p><p><strong>Results: </strong>A total of 32 patients were included, with the majority classified as IMDC intermediate risk. The Meet-URO score showed superior prognostic value for overall survival compared with IMDC (median 21 vs. 1-2 months across groups; 95% CI 1.83-20.17; p=0.043). A post-treatment NLR below 2.44 predicted improved progression-free survival (median 17 vs. 7 months; 95% CI 7.4-26.2; p=0.014) and remained independently significant. Neither FAN score nor eosinophil percentage provided prognostic discrimination. No survival differences were observed between treatment lines. Cytoreductive nephrectomy (78%) was associated with longer progression-free survival (9 vs. 3 months; HR: 3.72, 95% CI 1.15-12.02; p=0.028) and overall survival (21 vs. 3 months; HR 4.03, 95% CI 1.14-14.19; p=0.030).</p><p><strong>Conclusion: </strong>Cytoreductive nephrectomy, early NLR, and the Meet-URO score may have potential value for risk stratification in patients with mRCC receiving immunotherapy. In a real-world urology-led setting, these factors may support clinical decision-making and treatment selection. These findings should be considered exploratory and hypothesis-generating, given the limited sample size, and warrant confirmation in larger prospective studies.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"594124"},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933036","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":"Management and Treatment Strategies for Upper Tract Urothelial Carcinoma: Current Insights.","authors":"Anosh S Dadabhoy, Michael F Basin, Kanha C Shete, Hooman Djaladat","doi":"10.2147/RRU.S511428","DOIUrl":"10.2147/RRU.S511428","url":null,"abstract":"<p><p>Upper tract urothelial carcinoma (UTUC) is a relatively uncommon urologic malignancy that has historically a worse prognosis than urothelial carcinoma of the bladder due to higher rate of invasion and worse morbidity in patients. However, recent developments in treatment possess great potential for improved outcomes in these patients. This review compiles the most recent practices in treating this disease, and avenues for future modalities. Risk stratification of UTUC guides treatment and surveillance, with neoadjuvant chemotherapy employed in higher stage, to improve oncologic outcome. Surgical management for UTUC includes endoscopic management (EM) and kidney-sparing surgery (KSS) for low risk (LR) disease, and radical nephroureterectomy (RNU) for high risk (HR) disease. EM may follow a retrograde or antegrade approach, preserving renal function at the cost of increased risk of recurrence. Topical therapies provide great potential for low-cost, outpatient procedures for LR disease, but their efficacy is poorly characterized. While RNU remains the gold standard, robot-assisted nephroureterectomy is the dominant modality, with lower rates of perioperative complications while maintaining comparable outcomes with respect to the open approach. Perioperative intravesical therapy is universally incorporated to reduce the risk of intravesical recurrence. The POUT trial demonstrated improved disease-free survival with adjuvant platinum-based chemotherapy following RNU, establishing it as standard of care in locally advanced disease, while enfortumab vedotin in combination with pembrolizumab has demonstrated significant improvements in progression-free and overall survival in the metastatic setting. Future implementation of biomarker technologies discloses the potential for improved screening and surveillance at low-cost. Treatment strategies for UTUC are rapidly expanding due to advances in diagnostic technologies and the emergence of novel systemic agents, including antibody-drug conjugates and immune checkpoint inhibitors. Proper management requires accurate risk stratification, with EM suitable for LR disease and RNU for HR disease.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"511428"},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875041","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":"Use of Methenamine Hippurate in an Ageing Population: National Prescription Trends from Norway (2004-2020).","authors":"Patrick Juliebø-Jones, Bhaskar K Somani, Christian Beisland","doi":"10.2147/RRU.S596007","DOIUrl":"10.2147/RRU.S596007","url":null,"abstract":"<p><strong>Objective: </strong>To describe national trends in methenamine hippurate prescribing in Norway, including variations by age and sex.</p><p><strong>Methods: </strong>Data were extracted from the Norwegian Prescription Database for 2004-2020. Methenamine hippurate was identified using ATC code J01XX05. All prescriptions were included; no exclusion criteria were applied. Outcomes included number of users, prevalence per 1000 persons, and distribution by age and sex. Analyses were descriptive.</p><p><strong>Results: </strong>From 2004 to 2020, use of methenamine hippurate increased steadily, with an average annual rise of 5.3%, reaching 35,134 unique users in 2020. Overall prevalence increased from 3.8 to 6.5 per 1000 persons. Women accounted for most users throughout; female prescribing increased from 5.5 to 11.3 per 1000 persons, while male use rose modestly from 1.3 to 1.8 per 1000 persons. The proportion of male users declined from 18.8% to 13.8%. Use was strongly age dependent: individuals aged ≥80 years accounted for around 60% of users. In 2020, rates peaked among women aged >90 years (64.9 per 1000) versus 25.8 per 1000 among men of the same age. Marked regional variation was observed, with higher use in northern and rural regions.</p><p><strong>Conclusion: </strong>Methenamine hippurate use in Norway has increased substantially, driven mainly by rising use among older women. Although prescribed less frequently, use among men persists. This trend may reflect increased awareness of the burden of recurrent urinary tract infections and a shift towards non-antibiotic prophylaxis. Further research is needed to evaluate prescribing appropriateness, clinical effectiveness, and implications for antimicrobial stewardship.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"596007"},"PeriodicalIF":2.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779379","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}