Translational andrology and urology最新文献

{"title":"Expanding the therapeutic potential of GLP-1 receptor agonists: implications for male reproductive and perioperative urologic health.","authors":"Aditi Yellu, Joon Kyung Kim, Brendan K Wallace, Soum D Lokeshwar","doi":"10.21037/tau-2026-0618","DOIUrl":"https://doi.org/10.21037/tau-2026-0618","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"351"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SESN2 promotes ferroptosis in bladder cancer by negatively regulating the NRF2/FSP1 signaling axis.","authors":"Jianfeng Hu, Yangmin Wang, Yonghui Du, Xi'an Li, Zhiguo Zhang, Xuehai Liang, Junfeng Peng","doi":"10.21037/tau-2026-0472","DOIUrl":"https://doi.org/10.21037/tau-2026-0472","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer (BLCA) shows intrinsic ferroptosis resistance. Sestrin2 (SESN2) regulates ferroptosis in other diseases, but its role in BLCA is unknown. In this study, we sought to determine whether SESN2 contributes to the intrinsic ferroptosis resistance of BLCA and to elucidate the underlying molecular mechanisms.</p><p><strong>Methods: </strong>SESN2 expression was measured in BLCA tissues, RT4 cells, T24 cells, and normal controls by quantitative real-time polymerase chain reaction, western blot, and immunofluorescence. Ferroptosis markers [glutathione (GSH), malondialdehyde (MDA), and Fe²⁺] and nuclear factor erythroid 2-related factor 2 (NRF2)/ferroptosis suppressor protein 1 (FSP1) levels were assessed in tissues and cells. RT4 cells were transfected with SESN2 overexpression plasmid, and changes in GSH, MDA, and NRF2/FSP1 were examined. Inhibitors ML385 (NRF2) and iFSP1 (FSP1) were used to verify pathway involvement.</p><p><strong>Results: </strong>SESN2 was downregulated in BLCA tissues and cells. BLCA displayed a ferroptosis-resistant phenotype (higher GSH, lower MDA and Fe²⁺) with elevated NRF2/FSP1 expression. SESN2 overexpression reduced GSH, increased MDA and Fe²⁺, and downregulated NRF2/FSP1 expression. Inhibitor treatment further lowered NRF2/FSP1 expression and partially reversed the changes in GSH, MDA, and Fe²⁺.</p><p><strong>Conclusions: </strong>SESN2 is downregulated in BLCA and promotes ferroptosis by negatively regulating the NRF2/FSP1 axis. This study identifies a novel role of SESN2 in BLCA ferroptosis and suggests targeting this pathway as a potential therapeutic strategy.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"332"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of KangDuo and da Vinci robot-assisted ureteral reimplantation: a retrospective cohort study.","authors":"Han Bao, Qian Yang, Xiang Wang, Yu Zhang, Shubo Fan, Tongchen He, Hao Dong, Xinfei Li, Bing Wang, Hang Fan, Kunlin Yang, Liqun Zhou, Zhihua Li, Xuesong Li","doi":"10.21037/tau-2026-0540","DOIUrl":"https://doi.org/10.21037/tau-2026-0540","url":null,"abstract":"<p><strong>Background: </strong>Ureteral reimplantation is central to distal ureteral reconstruction, but evidence comparing emerging robotic platforms with the established da Vinci system remains limited. We compared the perioperative safety and mid-term outcomes of KangDuo Surgical Robot-01 (KD-SR-01)-assisted and da Vinci-assisted ureteral reimplantation.</p><p><strong>Methods: </strong>We retrospectively analyzed 153 patients who underwent robot-assisted ureteral reimplantation between January 2024 and December 2025. Platform allocation was nonrandom and reflected patient choice after standardized counseling. The primary outcome was mid-term surgical failure, defined as persistent symptoms or radiographic obstruction requiring continued urinary drainage or further intervention; secondary outcomes were operative time, estimated blood loss, postoperative hospital stay, postoperative renal function, and complications. The primary analysis was multivariable regression adjusted for baseline differences in case complexity, with Firth penalized models used for the rare binary outcomes. Propensity score matching was retained as a sensitivity analysis.</p><p><strong>Results: </strong>Before adjustment, the da Vinci group had longer strictures [5.0 (3.0-10.0) <i>vs.</i> 4.0 (3.0-5.0) cm; P=0.01] and more previous failed reconstructions (31.4% <i>vs.</i> 13.7%; P=0.03). All procedures were successfully completed without conversion. KD-SR-01 was associated with a longer operative time [adjusted difference, 13.91 minutes; 95% confidence interval (CI): 1.94-25.88; P=0.02]. No significant differences were observed in estimated blood loss, postoperative hospital stay, postoperative serum creatinine, or postoperative estimated glomerular filtration rate. Complications occurred in 3/51 (5.9%) KD-SR-01 and 7/102 (6.9%) da Vinci cases (adjusted odds ratio, 0.91; 95% CI: 0.20-3.49); surgical failure occurred in 1/51 (2.0%) and 2/102 (2.0%), respectively (adjusted odds ratio, 1.20; 95% CI: 0.09-10.93). Results were consistent in the propensity score-matched sensitivity analysis.</p><p><strong>Conclusions: </strong>KD-SR-01-assisted ureteral reimplantation is safe and feasible, with perioperative safety and mid-term clinical outcomes comparable to those of da Vinci-assisted surgery. Although the longer operative time with KD-SR-01 may reflect the surgeon's early learning curve and a more methodical operative workflow, these data suggest that the platform may be a feasible alternative in selected reconstructive cases.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"325"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interpretable LASSO-Boruta nomogram for non-muscle-invasive bladder cancer recurrence after intravesical instillation.","authors":"Bingjie Li, Guangyun Ji, Wenting Wang, Lina Guo","doi":"10.21037/tau-2026-0557","DOIUrl":"https://doi.org/10.21037/tau-2026-0557","url":null,"abstract":"<p><strong>Background: </strong>Recurrence remains a major clinical challenge in non-muscle-invasive bladder cancer (NMIBC), highlighting the need for interpretable tools for individualized risk assessment. This study aimed to develop a transparent model that estimates recurrence risk in patients with NMIBC after transurethral resection of bladder tumor (TURBT) and intravesical instillation.</p><p><strong>Methods: </strong>We reviewed 200 patients with NMIBC who received TURBT and postoperative intravesical instillation at the Department of Urology, The Affiliated Hospital of Xuzhou Medical University, from January to December 2020. Recurrence status was determined from follow-up records. We collected baseline variables, preoperative laboratory results, and clinicopathological data. Patients were divided into training and validation sets (7:3). We screened predictors with multivariate Cox regression, least absolute shrinkage and selection operator (LASSO)-Cox regression, and Boruta analysis before building the nomogram. Model performance was checked with receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA). Shapley additive explanations (SHAP) analysis was used for interpretation, and an R Shiny application was built.</p><p><strong>Results: </strong>Of the 200 patients, recurrence was observed in 90 cases. The final identified predictors were smoking, hypertension, hemoglobin (Hb), and serum Na. The nomogram showed stable performance, with time-dependent areas under the curves (AUCs) of 0.862, 0.918, and 0.948 in the training set and 0.725, 0.870, and 0.919 in the validation set at 12, 36, and 60 months, respectively. SHAP analysis ranked Hb as the main contributor; higher Hb and serum Na indicated lower recurrence risk, while smoking and hypertension indicated higher risk.</p><p><strong>Conclusions: </strong>This model provided internally validated recurrence-risk estimates; external validation and usability testing are required before clinical use.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"341"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of preoperative frailty with health-related quality of life and urinary function after robot-assisted radical prostatectomy.","authors":"Hisanori Taniguchi, Junichi Ikeda, Monta Inoue, Yuki Masuo, Hidefumi Kinoshita","doi":"10.21037/tau-2026-0589","DOIUrl":"https://doi.org/10.21037/tau-2026-0589","url":null,"abstract":"<p><strong>Background: </strong>Frailty may influence outcomes after robot-assisted radical prostatectomy (RARP), but its association with longitudinal patient-reported outcomes remains unclear. This study aimed to examine the association of preoperative frailty, assessed using the Geriatric (G) 8 screening tool, with longitudinal health-related quality of life (HRQOL) and urinary status in patients who underwent RARP.</p><p><strong>Methods: </strong>We retrospectively analyzed 328 patients who underwent RARP at a single institution. Patients were preoperatively classified into high, intermediate, and low G8 groups. HRQOL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G) and Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaires. Urinary status was evaluated using the urinary incontinence subscale of the Expanded Prostate Cancer Index Composite (EPIC) and daily pad usage.</p><p><strong>Results: </strong>Preoperative G8 scores demonstrated substantial overlap across age categories, suggesting that chronological age alone did not accurately reflect frailty status. Linear mixed-effects models showed a significant effect of time on FACT-G (P=0.004) and FACT-P (P<0.001), as well as significant main effects of G8 classification on both measures (both P<0.001); however, the time-by-G8 interaction was not significant for either FACT-G (P=0.42) or FACT-P (P=0.14). In models restricted to postoperative assessments and adjusted for baseline HRQOL and age, the time-by-G8 interactions remained nonsignificant, indicating no evidence of differential postoperative HRQOL trajectories among the G8 groups. Urinary status measured by EPIC significantly improved over time (P<0.001), and, after adjustment for baseline urinary status and age, no significant time-by-G8 interaction was observed (P=0.29). Kaplan-Meier analysis revealed no significant difference in time to urinary continence recovery across G8 groups (log-rank P=0.82).</p><p><strong>Conclusions: </strong>Lower preoperative G8 scores were associated with persistently lower HRQOL before and after RARP, without evidence of a significantly different longitudinal HRQOL trajectory. After accounting for baseline urinary status and age, there was no clear evidence of different postoperative urinary recovery trajectories among the G8 groups, and time to continence recovery did not significantly differ among groups. Frailty screening may provide clinically meaningful information for preoperative counseling and shared decision-making in patients undergoing RARP.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"324"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal-incision hydrocelectomy reduces bleeding, but has it solved recurrence?-a look back at a century of technique.","authors":"Takumi Takeuchi, Mami Hattori-Kato","doi":"10.21037/tau-2026-0742","DOIUrl":"https://doi.org/10.21037/tau-2026-0742","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"319"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative management of infants with ureteropelvic junction obstruction: a retrospective cohort study of PICU transfer, complications, and length of stay.","authors":"Haoxuan Yang, Zeyuan Sui, Sheng Tang, Yuan Chen, Zixu Yang, Runlong Wang, Ziyue Ma, Lei Du, Wenyong Xue, Jinchun Qi","doi":"10.21037/tau-2026-0465","DOIUrl":"https://doi.org/10.21037/tau-2026-0465","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Postoperative management of infants with ureteropelvic junction obstruction (UPJO) is challenging due to their inability to express symptoms and risk of rapid deterioration. This study aimed to describe our institutional experience with a combined urology-pediatric intensive care unit (PICU) protocol and to explore complication patterns, length of stay (LOS), and costs in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 84 consecutive infants (≤12 months) who underwent laparoscopic dismembered pyeloplasty (LP) for UPJO-related hydronephrosis at The Second Hospital of Hebei Medical University from December 2020 to December 2025 were retrospectively analyzed. Patients were divided into Group A (PICU transfer, n=62) and Group B (general ward care, n=22). Surgical outcomes, complications graded by the Clavien-Dindo classification, LOS, and hospitalization costs were compared. Propensity score matching (PSM) was performed as an exploratory analysis to balance baseline differences. Univariable and multivariable logistic regression analyses were performed to identify factors associated with PICU transfer and adverse outcomes, defined as Clavien-Dindo grade ≥ III. All analyses explicitly acknowledge confounding by indication and baseline non-comparability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the full cohort, Group A was significantly younger at surgery (mean 4.77 &lt;i&gt;vs.&lt;/i&gt; 9.23 months, P&lt;0.001) and incurred higher hospitalization costs (median 37,080.50 &lt;i&gt;vs.&lt;/i&gt; 31,072.26 CNY, P&lt;0.001); operative time, blood loss, and LOS were similar. The proportion of patients with Clavien-Dindo grade ≥ II complications was lower in Group A (74.2% &lt;i&gt;vs.&lt;/i&gt; 100%, P=0.008), as was the incidence of any respiratory complication (67.7% &lt;i&gt;vs.&lt;/i&gt; 95.5%, P=0.01), driven primarily by a marked reduction in bronchitis (17.7% &lt;i&gt;vs.&lt;/i&gt; 50.0%, P=0.003). Four patients (18.2%) in Group B required unplanned PICU transfer due to postoperative deterioration. In the PSM cohort (12 pairs), Group A had a lower proportion of Clavien-Dindo grade ≥II complications (58.3% &lt;i&gt;vs.&lt;/i&gt; 100%, P=0.01) and a lower incidence of bronchitis (0% &lt;i&gt;vs.&lt;/i&gt; 41.7%, P=0.01), but the small sample renders these estimates unstable. In multivariable analysis, younger age [odds ratio (OR), 0.61; 95% confidence interval (CI): 0.46-0.75; P&lt;0.001] and operative side (OR, 0.15; 95% CI: 0.03-0.60; P=0.01) were independently associated with PICU transfer. No evaluated factor was independently associated with adverse outcomes (Clavien-Dindo grade ≥ III). A positive correlation existed between Clavien grade and the number of concurrent complication types; complications ≥ Grade III significantly prolonged LOS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Infants after LP face a substantial burden of non-surgical complications. In this retrospective cohort, PICU transfer was associated with younger age and operative side after adjustment, while no independent association was identi","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"337"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What can we learn from past mistakes in genital surgery?","authors":"Jonathan Charles Goddard","doi":"10.21037/tau-2026-0740","DOIUrl":"https://doi.org/10.21037/tau-2026-0740","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"323"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of radical prostatectomy, radiotherapy, and radiotherapy plus androgen deprivation therapy for high-risk and very high-risk prostate cancer: a narrative review.","authors":"Kaung Hset Tun, Xingyu Xiong, Hang Xu, Lu Yang","doi":"10.21037/tau-2026-0553","DOIUrl":"https://doi.org/10.21037/tau-2026-0553","url":null,"abstract":"<p><strong>Background and objective: </strong>High-risk and very high-risk prostate cancer (PCa) accounts for approximately 15-20% of newly diagnosed cases and are associated with substantial risk of disease progression, metastasis, and cancerspecific mortality. The comparative effectiveness of radical prostatectomy (RP), external beam radiotherapy (EBRT), and radiotherapy combined with androgen deprivation therapy (RT + ADT) remains uncertain because randomized head-to-head trials are lacking. This narrative review aims to synthesize the comparative effectiveness of RP, EBRT, and RT + ADT in patients with high-risk and very high-risk PCa, with respect to survival outcomes, optimal ADT duration, and toxicity/quality-of-life profiles.</p><p><strong>Methods: </strong>Literature searches were conducted across PubMed, Cochrane Library (CENTRAL), and ClinicalTrials.gov through May 2026. Studies comparing RP, EBRT, and/or RT + ADT in patients with high-risk PCa [prostate-specific antigen (PSA) ≥20 ng/mL, Gleason score 8-10/International Society of Urological Pathology (ISUP) grade ≥4, or clinical stage ≥T3a] were included. Primary outcomes were overall survival (OS), prostate cancer-specific survival (PCSS), and biochemical recurrence-free survival (bRFS).</p><p><strong>Key content and findings: </strong>Observational studies comparing RP and RT-based strategies have reported conflicting results for OS: some studies reported more favorable outcomes with RP [hazard ratio (HR) 1.60, 95% confidence interval (CI): 1.25-2.05 for EBRT + ADT <i>vs.</i> RP], whereas others reported more favorable outcomes with RT-based strategies (HR 1.22, 95% CI: 1.05-1.43 for RP <i>vs.</i> EBRT plus brachytherapy). For patients with Gleason score 9-10 disease, observational analyses suggested that EBRT with brachytherapy boost was associated with lower prostate cancer-specific mortality compared with RP (HR 0.38, 95% CI: 0.21-0.68). For RT-treated patients, randomized controlled trials (RCTs) support the use of 18-24 months of ADT. Quality-of-life analyses consistently showed worse urinary incontinence and sexual dysfunction after RP, worse bowel symptoms after RT, and compounded toxicity with multimodal therapy.</p><p><strong>Conclusions: </strong>For patients with high-risk and very high-risk PCa, radiotherapy combined with 18-24 months of ADT is supported by evidence from randomized trials compared with radiotherapy alone. Comparative survival evidence between RP and RT-based strategies remains conflicting and is limited by observational designs and selection bias. Treatment selection should be individualized according to patient age, comorbidity burden, tumor characteristics, and quality-of-life preferences. Randomized trials directly comparing contemporary RP with modern RT + ADT are urgently needed.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"346"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing spatial perception of learners during holmium laser enucleation of the prostate (HoLEP).","authors":"Nabila Reem Khondakar, Amir Patel, Jenny Guo, Matt Pearson, Shaan Setia, Amy E Krambeck, Perry Xu","doi":"10.21037/tau-2026-0443","DOIUrl":"https://doi.org/10.21037/tau-2026-0443","url":null,"abstract":"<p><strong>Background: </strong>Holmium laser enucleation of the prostate (HoLEP) has a steep learning curve. Specific educational efforts to improve HoLEP training has not been extensively studied. The aim of this study was to assess the spatial perception of urology residents (learners) HoLEP videos to improve future educational efforts.</p><p><strong>Methods: </strong>A cross-sectional simulation-based observational study during an academic urology conference was performed. A HoLEP recording was shown to resident physicians and paused at 5 time points. Resident physicians were then asked to mark down coordinates on diagrams of prostates in the coronal, axial and sagittal dimensions at each pause to denote where they perceived the laser was pointing.</p><p><strong>Results: </strong>Twenty-one urology residents (learners) participated in the study, of whom, 47.6% had prior HoLEP exposure. The learners plotted perceived coordinates at pre-designated time points in 3 dimensions throughout a HoLEP, totaling 315 coordinates. Learners perceived more accurately in the coronal dimension and were most accurate in identifying the verumontanum (the first time point of the procedure). Those with prior HoLEP exposure, as well as senior residents, were significantly more likely to accurately pinpoint the verumontanum in the coronal dimension (P=0.04, 0.03 respectively). Prior HoLEP exposure and post-graduate year (PGY)-level was not associated with accurately identifying the other time points in all dimensions.</p><p><strong>Conclusions: </strong>Spatial understanding during a HoLEP is challenging and learners are inaccurate in pinpointing coordinates while watching endoscopic recordings alone, regardless of PGY-level and prior HoLEP exposure. Learners appear to perceive in the coronal dimension more accurately as opposed to the axial or sagittal dimensions. This could be used to direct future educational efforts for teaching HoLEP.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"330"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}