Therapeutic Advances in Urology最新文献

{"title":"Advancements in minimally invasive urology and uro-technology: current status, evolution and future prospects.","authors":"Bhaskar Somani","doi":"10.1177/17562872251329898","DOIUrl":"10.1177/17562872251329898","url":null,"abstract":"","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251329898"},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic reconstruction for benign upper urinary tract obstruction: a review of the current literature.","authors":"Rebeca Gonzalez Jauregui, Rohan G Bhalla, Karen Doersch, Brian J Flynn","doi":"10.1177/17562872251326785","DOIUrl":"10.1177/17562872251326785","url":null,"abstract":"<p><p>The field of reconstructive urology has seen a paradigm shift in the surgical approach for intra-abdominal cases, resulting in an increased preference for minimally invasive techniques. The introduction of the surgical robot has led to exponential growth in innovative approaches, reflecting the ongoing efforts to improve patient outcomes and address the limitations of open and laparoscopic surgery. This review article summarizes the knowledge gained in the last 10 years about adult robotic ureteral reconstruction. A non-systematic literature review was conducted on February 18, 2024 using Medline, PubMed, Web of Science, and Embase libraries. Studies published in English since 2014 reporting at least five robotic ureteral reconstructive cases for the management of benign ureteral obstruction in adults were included. A narrative review focusing on robotic ureteral reconstructive techniques, their associated success and complication rates, and how the robotic approach compares to open and laparoscopic reconstruction was performed. The current literature demonstrates increased utilization of the robotic platform in reconstructive urological procedures. Robotic surgery has been shown to be associated with shorter learning curves, lower surgeon fatigue, better visualization and equivalent results to those seen with laparoscopic surgery. While the literature is limited by a lack of comparative data, well-designed randomized controlled trials, and standardized criteria for defining and measuring success, this review demonstrates the safety, feasibility, and efficacy of robotic ureteral reconstruction for managing benign ureteral strictures, confirming it as a viable alternative to open and laparoscopic surgery.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251326785"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab and olaparib in a cisplatin-refractory testicular cancer patient with a high TMB: first case report.","authors":"Nils C H van Creij, Gerald Klinglmair, Leonhard Gruber, Antonia Partl, Alain G Zeimet, Frédéric R Santer, Simon Schnaiter, Roman Mayr, Felizian Lackner, Zoran Culig, Andreas Seeber, Renate Pichler","doi":"10.1177/17562872251322648","DOIUrl":"https://doi.org/10.1177/17562872251322648","url":null,"abstract":"<p><p>Germ cell tumors (GCTs) represent about 5% of urological cancers affecting mostly younger males with increasing incidence in the last decades. GCTs are very sensitive to cisplatin-based therapy and are highly curable regardless of metastatic stage, likely based on having inherited unique mechanisms of sensitivity to DNA damage and other stressors to prevent germline mutations. Here, we present the first case of a 60-year Caucasian male with a heavily pretreated, cisplatin-refractory extragonadal non-seminomatous GCT (choriocarcinoma) treated with pembrolizumab and olaparib based on high programmed death-ligand 1 expression (tumor proportion score 50% and a combined positive score 55%) high tumor mutational burden, borderline genomic loss of heterozygosity, and a heterozygous variant of uncertain significance in the DNA repair gene <i>ATM</i>, as confirmed by next-generation sequencing (NGS) analysis. Despite a notable decrease in b-hCG within 4 weeks after starting pembrolizumab and olaparib, b-hCG increased steadily again afterward. In addition, the patient developed an immune-related pneumonitis with a fatal outcome 3 months later. NGS with subsequent targeted treatment possibilities might present a helpful step toward precision medicine in GCT patients who have exhausted all other conventional treatment options, and genetic testing should therefore be offered to patients prior to progression.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251322648"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The expanding role of next-generation imaging in prostate cancer management: a cross-sectional survey exploring the clinical practice of uro-oncologists in North-Eastern Italy; on behalf of GUONE (Gruppo Uro-Oncologico del Nord-Est).","authors":"Fabio Matrone, Luca Urso, Rossano Girometti, Jerry Polesel, Matteo Sepulcri, Francesco Pierantoni, Paolo Artioli, Anna Caliò, Irene Campo, Alessia Cimadamore, Enrico Munari, Luca Ongaro, Valentina Orlando, Camilla Sachs, Alessandro Veccia, Alessandro Antonelli, Roberto Bortolus, Matteo Brunelli, Orazio Caffo, Laura Evangelista, Matteo Salgarello, Umberto Basso, Rocco De Vivo, Mario Gardi, Andrea Guttilla, Marco Andrea Signor, Fabio Zattoni, Filippo Alongi, Giampaolo Montesi, Gianluca Giannarini","doi":"10.1177/17562872251321971","DOIUrl":"10.1177/17562872251321971","url":null,"abstract":"<p><strong>Background: </strong>Next-generation imaging (NGI) technologies such as multiparametric magnetic resonance imaging (mpMRI) and total-body NGI (tbNGI) methodologies including choline, fluciclovine or PSMA positron emission tomography/computed tomography (PET/CT), whole-body MRI (wbMRI), and PET/MRI are becoming increasingly available, but their use in different prostate cancer (PCa) settings is under debate. The Gruppo Uro-Oncologico del Nord-Est (GUONE) designed a survey to explore the current clinical practice of NGI utilization in a specific macro-region in North-Eastern Italy.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted by administering an anonymous online multiple-choice questionnaire to uro-oncologists practicing in North-Eastern Italy, using the Google Forms^® platform. The use of NGI was investigated in the following settings: primary staging of PCa; management of biochemical (BCR) and local recurrence (LR); re-staging in metastatic hormone-sensitive PCa (mHSPC), metastatic castration-resistant PCa (mCRPC), non-metastatic CRPC (nmCRPC), and oligometastatic PCa (OMPC).</p><p><strong>Results: </strong>In all, 100 uro-oncologists accessed and completed the survey. In primary N/M staging, the use of tbNGI increases in accordance with NCCN risk groups. Re-staging with choline and PSMA PET/CT is the prevalent choice in the case of BCR after radical prostatectomy. Moreover, when the PSA value rises, there is a parallel increased use of tbNGI. When an LR is suspected, PSMA PET/CT plus mpMRI is the most selected option. Re-staging with tbNGI (PSMA PET/CT) is preferred in mHSPC, mCRPC, and nmCRPC patients in case of progression of disease. Overall, there is a limited use of wbMRI and PET/MRI in all the settings investigated.</p><p><strong>Conclusion: </strong>Our survey describes the expanding role of NGI modalities in the management of PCa patients, from primary staging and re-staging to management of advanced PCa and assessment of treatment response. Several controversial issues have emerged, which need to be addressed in prospective studies to develop a standardized and cost-effective NGI utilization.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251321971"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and testicular cancer survivorship health-related quality of life: a scoping review.","authors":"Michael J Rovito, Keith Brazendale, Samantha Gibson, Sydney Martinez, Ciaran Fairman, Craig Badolato, Timothy Lyon, Bryce Baird, Jaclyn Langan, M K Leslie","doi":"10.1177/17562872251322658","DOIUrl":"10.1177/17562872251322658","url":null,"abstract":"<p><strong>Background: </strong>While the benefits of physical activity (PA) for cancer survivors are well-documented, there is limited research specifically exploring its effects on health-related quality of life (HRQoL) among testicular cancer (TC) survivors. This review aims to examine the available literature on the relationship between PA and HRQoL in TC survivors post-treatment.</p><p><strong>Objective: </strong>To identify and synthesize existing studies on the effects of PA on HRQoL outcomes in TC survivors.</p><p><strong>Eligibility criteria: </strong>Studies that examined the relationship between PA, TC survivorship, and HRQoL across various phases of survivorship were included. Only peer-reviewed articles and gray literature addressing these topics were considered.</p><p><strong>Sources of evidence: </strong>A systematic search was conducted across seven databases and gray literature. Articles were evaluated based on titles, abstracts, and full-text reviews for inclusion.</p><p><strong>Charting methods: </strong>Following Arksey and O'Malley's scoping review framework and PRISMA-ScR guidelines, studies were charted for key findings regarding the effects of PA on cancer-related fatigue, psychosocial outcomes, and HRQoL in TC survivors. The search also focused on identifying barriers to PA adherence and gaps in the current literature.</p><p><strong>Results: </strong>Three studies were examined: one experimental study, one feasibility study, and one cross-sectional study. Findings suggested that PA interventions could reduce cancer-related fatigue, improve psychosocial well-being, and enhance HRQoL indicators such as vitality, self-esteem, and social functioning. High-intensity interval training showed short-term benefits, while low-intensity activities demonstrated feasibility for broader adoption. Adherence barriers included treatment side effects and psychosocial factors. Limitations included small sample sizes, self-reported data, and lack of long-term follow-up.</p><p><strong>Conclusion: </strong>The findings suggest that PA can improve HRQoL in TC survivors, but significant gaps remain, particularly in terms of longitudinal studies, diverse populations, and tailored interventions. Future research should focus on developing scalable, sustainable PA interventions that address adherence and long-term health outcomes for TC survivors.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251322658"},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising public interest in stem cell therapy for erectile dysfunction: an analysis of public perception and a review of the literature.","authors":"Muhammed A M Hammad, Jake Miller, Mark I Sultan, Elia Abou Chawareb, Hana S Nakamura, Juan R Martinez, Supanut Lumbiganon, Lawrence Jenkins, David W Barham, Dhiresh Bandaru, Jessica M Yih, Faysal A Yafi","doi":"10.1177/17562872251322651","DOIUrl":"10.1177/17562872251322651","url":null,"abstract":"<p><strong>Purpose: </strong>The use of alternative treatment modalities for erectile dysfunction (ED) beyond phosphodiesterase inhibitors continues to grow within the practice of Urology. Utilizing U.S. Google trends as a novel epidemiological tool for geographically associating patient search intent, our study aims to capture trends relating to interest in stem cell therapy (SCT) as a potential treatment for ED.</p><p><strong>Methods: </strong>An online search was conducted to identify centers in the United States offering stem cell therapy (SCT) for erectile dysfunction (ED), using specific keywords such as \"ED treatment,\" \"stem cells for ED,\" and \"sexual health stem cell.\" The geographic distribution of these centers was mapped, and their publicly available information was evaluated based on strict inclusion criteria, including direct claims of SCT efficacy for ED and oversight by a licensed urologist. The public interest in SCT treatment was quantified using Google Trends data from July 2018 to July 2023, utilizing search terms related to SCT and comparing them to terms associated with alternative regenerative therapies like platelet-rich plasma and shockwave treatments, to extract the direction and magnitude of national interest over the preceding 5 years. The PubMed, Cochrane Library, and EMBASE databases were then searched from inception to May 2024 regarding evidence for the use of SCT to treat ED.</p><p><strong>Results: </strong>Despite insufficient evidence, public search interest demonstrates an upward trajectory of this treatment when compared to alternative regenerative therapies for ED. This increased interest in SCT as a potential treatment option for ED may be linked to the marketing efforts of commercial entities. Throughout the qualitative analysis of advertisement sources, only two websites (Stem Cells Transplant Institute, and Ambrose Cell Therapy) summarized the collective results of a directed clinical trial investigating the utility of SCT in ED patients.</p><p><strong>Conclusion: </strong>Our study demonstrates the public prevalence of patients seeking SCT as a treatment modality for ED is increasing. In addition, varied sources nationwide promote SCT despite limited scientific evidence and consensus. This disparity calls for additional prospective research on the viability, efficacy, and long-term safety of SCT in the context of ED.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251322651"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stone-free rate of laser lithotripsy for large pediatric stones: 15-year experience from a tertiary endourology pediatric center.","authors":"Sohani N Dassanayake, Victoria Jahrreiss, Stephen Griffin, Bhaskar K Somani","doi":"10.1177/17562872251322673","DOIUrl":"10.1177/17562872251322673","url":null,"abstract":"<p><strong>Background: </strong>Pediatric urolithiasis, while less common than in adults, is increasing in incidence. However, current guidelines on the optimal management of this condition vary. Technological advances have led to improvements in the quality and size of ureteroscopes, thus enabling their use in children. Despite this, there remains some hesitancy about using ureteroscopic lithotripsy in the pediatric population, particularly in cases of large stones ⩾10 mm.</p><p><strong>Objectives: </strong>In this study, our aim was to evaluate the efficacy and safety of ureteroscopy and laser stone fragmentation (URSL) for managing pediatric patients with a cumulative stone burden of ⩾10 mm in our tertiary referral center.</p><p><strong>Methods: </strong>A dataset was collected of pediatric renal tract stone patients treated at a single tertiary urological center between June 2010 and May 2024 (15 years). Pediatric patients undergoing URSL procedures for a minimum cumulative stone burden ⩾10 mm were included. A retrospective analysis of the dataset was conducted. The primary outcomes measured were stone-free rates (SFR), complications classified according to the Clavien-Dindo classification, and hospital length of stay.</p><p><strong>Results: </strong>A total of 61 pediatric patients with a mean age of 10 years (range: 2.3-16) underwent 83 URSL procedures in a tertiary endourology pediatric center over a 15-year period (2010-2024). The median initial stone burden was 17 mm (IQR: 12.5-24 mm), acquired from preoperative ultrasonography (USS). Results showed a first-pass SFR of 63.9% and a cumulative SFR of 93.4% (on USS) following one or multiple URSL procedures (1.4 procedures/patient). Immediate postoperative complications were minimal, with 6% experiencing complications classified as Clavien-Dindo I or II. The average hospital length of stay was 1.4 days.</p><p><strong>Conclusion: </strong>The findings in this study support that URSL is effective in treating pediatric urolithiasis, even for larger stone burdens. Further research is needed to standardize guidelines and optimize management strategies in this population.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251322673"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing a new device for direct in-scope suction technique during flexible ureteroscopy for kidney stone disease: an EAU Section of Endourology prospective multicenter audit using the GLITZ system.","authors":"Vineet Gauhar, Olivier Traxer, Nanjappa Madappa Kandarthanda, Bhaskar K Somani, Daniele Castellani, Ravindra B Sabnis, Deepak Ragoori","doi":"10.1177/17562872251320807","DOIUrl":"10.1177/17562872251320807","url":null,"abstract":"<p><strong>Background: </strong>The direct in-scope suction (DISS) involves a two-way adaptor mounted on a scope to aspirate and irrigate the pelvicalyceal system during flexible ureteroscopy. While integrated suction single-use scopes manage small dust particles effectively, they cannot remove particles >250 µm and are limited by single use.</p><p><strong>Objectives: </strong>To evaluate perioperative outcomes of the GLITZ system, a lightweight suction accessory for flexible ureteroscopes, facilitating laser lithotripsy with integrated aspiration.</p><p><strong>Design: </strong>Prospective, multicenter study.</p><p><strong>Methods: </strong>The GLITZ system, a 100 g trigger mounted on the ureteroscope handle, integrates with an irrigation and aspiration apparatus featuring a flow-regulating sensor. A finger-trigger activates suction, stopping irrigation until released, enhancing visibility and safety by automatically stopping irrigation if blockages occur. The study involved 29 patients (November 2023-April 2024). Procedures were performed using a disposable 7.5 Fr ureteroscope, ureteral access sheath, and thulium fiber or 100 W holmium:YAG laser. Surgeons evaluated ease of use and performance. Stone-free status was evaluated at a 30-day CT scan and classified as follows: Grade A: zero RF; Grade B: single RF not up 2 mm; Grade C: single RF 2.1-4 mm; and Grade D: single/multiple RFs > 4 mm. Data are reported as median and (interquartile range).</p><p><strong>Results: </strong>A total of 31.1% of patients were female. The median age was 54 years. Pain was the most common complaint, and 41.8% had multiple stones. GLITZ system showed satisfactory performance in 93.1% of cases, with complete dust aspiration achieved in 62.1%. Device dislodgement occurred in 24.1% of cases. Median operative time was 40 min, achieving postoperative CT at 30 days confirmed Grade A stone-free status in 75.9%. Fever was the most common complication (10.3%), with no sepsis case.</p><p><strong>Conclusion: </strong>The GLITZ system in DISS shows effectiveness with a 96.6% stone-free rate (Grade A + B) at 30 days, indicating strong potential for flexible ureteroscopy, though additional studies are needed to optimize flow rates and usability.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251320807"},"PeriodicalIF":2.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric urodynamic studies: emerging technologies and new frontiers.","authors":"Tayla Fay, Aniruddh V Deshpande, Thomas Blanc, Chris Kimber, Kiarash Taghavi","doi":"10.1177/17562872251315927","DOIUrl":"10.1177/17562872251315927","url":null,"abstract":"<p><p>Over the past two decades, there have been significant developments in paediatric urodynamic studies focusing on less-invasive monitoring devices, as well as re-defining normative values. This article reviews current paediatric urodynamic study methods and their reliability, and discusses new emerging ambulatory urodynamics and novel telemetric urodynamic devices. Traditional urodynamic studies are performed in specialised suites in real-time with artificial bladder filling. Ambulatory models allow for measurements in a more authentic environment and with natural bladder filling. Novel implanted telemetric monitoring devices provide a catheter-free solution but are inherently invasive in nature. Exploration of indirect measurements to obtain urodynamic data warrant further investigation. Definitive progress will require strong and sustained collaboration between end users and developers.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251315927"},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic injection of botulinum toxin to prevent pouch contractions in a patient with Indiana pouch diversion.","authors":"Emre Albayrak, Naşide Mangir, Hasan Serkan Doğan, Serdar Tekgül","doi":"10.1177/17562872251317930","DOIUrl":"10.1177/17562872251317930","url":null,"abstract":"<p><p>Continent urinary diversion is the preferred method of bladder substitution for many patients who undergo cystectomy for benign conditions. Additional interventions are often necessitated after a continent diversion to achieve continence. One such procedure is the injection of botulinum toxin into the neobladder. Previous injections into the pouch bladder have been performed percutaneously. Here we present a less invasive endoscopic injection technique where flexible equipment has been used successfully to inject botulinum toxin into the pouch bladder via the pouch stoma. We demonstrate the feasibility of the injection and its efficacy in reducing pouch contractions and the patient's symptoms. A 36-year-old female presented with persistent urinary incontinence symptoms 1 year after Indiana pouch diversion. Despite previous conservative measures and ileocecal valve reinforcement surgery, incontinence persisted. The endoscopic injection, facilitated through the pouch stoma, proved effective in decreasing muscle contractions and alleviating spasm-like sensations without observed side effects. This case shows the feasibility, safety and efficacy of botulinum toxin injection into Indiana pouch endoscopically.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"17 ","pages":"17562872251317930"},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}