Translational andrology and urology最新文献

{"title":"Assessments of neurogenic bladder dysfunction induced by spinal cord injury, bladder outlet obstruction and diabetes: a comparative study of rat models.","authors":"Shuwen Sun, Jingcheng Zhang, Ailiyaer Ainiwaer, Yuchao Liu, Danjing Shen, Yufeng Jiang, Hanyang Chen, Ayinuer Bohetiyaer, Tong Wu, Yuchen Gao, Wei Li, Yunfei Xu, Tianyuan Xu, Yang Yan","doi":"10.21037/tau-2025-234","DOIUrl":"10.21037/tau-2025-234","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic bladder (NB) refers to urinary storage and voiding dysfunction resulting from neurological disorders. Animal models of NB are commonly used in preclinical studies, but the distinct characteristics of various modeling techniques are infrequently compared. This study aimed to evaluate and compare the functional and pathological outcomes of different NB rat models.</p><p><strong>Methods: </strong>Three rat NB models were induced by spinal cord injury (SCI), bladder outlet obstruction (BOO), and diabetes. Blood urea nitrogen (BUN) and serum creatinine (Scr) levels, along with urine flow dynamics, were assessed at weeks 1, 2, 4, and 8. At the 10-week endpoint, animals were euthanized, and bladder weights were recorded for each specimen. Pathological analysis and western blotting were conducted to evaluate bladder muscle fibrosis.</p><p><strong>Results: </strong>All three rat NB models were successfully established. At week 8, the average maximum/minimum bladder pressures for the SCI, BOO, and diabetic NB rats were 34.0/27.8, 40.4/30.2, and 32.1/28.8 mmH₂O, respectively, while bladder capacity and residual volumes were 4.32/4.245, 5.35/5.084, and 4.20/4.048 mL, respectively. The average Scr levels were 52.2, 54.6, and 37.7 mmol/L, and BUN levels were 15.4, 13.8, and 13.9 mmol/L for the three groups. Compared to the control, bladder weights and volumes were significantly increased in the NB groups. Histopathological examination revealed marked thickening and disorganization of the muscle bundles in NB bladders, along with notable inflammatory cell infiltration within the epithelial layer. Immunohistochemical and western blot analyses showed increased fibronectin expression in the NB model bladders.</p><p><strong>Conclusions: </strong>The three NB rat models effectively replicated clinical and pathological features, including reduced bladder compliance, renal dysfunction, and bladder fibrosis. Among these models, SCI offers the fastest method for inducing NB. Renal function impairment was more pronounced in the SCI- and BOO-induced NB models, with BOO resulting in the most significant pathological changes in the bladder.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2254-2268"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065497","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":"Outcomes of drug-coated balloon urethral dilation in patients with stricture recurrence after urethroplasty.","authors":"Elizabeth P Kwenda, Ashorne K Mahenthiran, Ramzy T Burns, Matthew J Mellon, Lawrence L Yeung","doi":"10.21037/tau-2025-49","DOIUrl":"10.21037/tau-2025-49","url":null,"abstract":"<p><strong>Background: </strong>Stricture recurrence after urethroplasty can be challenging to manage. Endoscopic intervention has been used with low success within this population. Optilume is a paclitaxel coated balloon dilator that has demonstrated high urethral patency rates and low risk of adverse events in patients with recurrent anterior urethral strictures when compared to endoscopic intervention. The objective of this study was to evaluate the utility of Optilume for treatment of stricture recurrence after urethroplasty.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients who underwent paclitaxel drug-coated balloon (DCB) dilation for urethral stricture recurrences after urethroplasty at two institutions between June 2022 and September 2024. Baseline patient characteristics were recorded including age, stricture etiology, and prior repair. The primary outcome was freedom from any repeat intervention.</p><p><strong>Results: </strong>Of the 146 men who underwent DCB dilation at our institutions, 19 had stricture recurrence after urethroplasty and were included in our analysis. The mean age was 55 years (standard deviation, 18 years; range, 34-82 years). Idiopathic strictures were most predominant (42%), followed by iatrogenic (21%), lichen sclerosis associated (16%), radiation induced (11%), and trauma induced (11%). Stricture locations were bulbar (47%), penile (32%), membranous (16%), and prostatic (5%). Prior urethroplasties were: 9 buccal mucosal graft (BMG) augmentation, 7 excision and primary anastomosis (EPA), 1 scrotal skin graft, 1 prior hypospadias repair and 1 rectourethral fistula repair with EPA and gracilis flap interposition. Sixty-three percent of patients underwent endoscopic intervention prior to DCB dilation. Average time from urethroplasty to DCB dilation was 43±42 months. The median follow-up was 228 days with interquartile range of 182 to 369 days. Two patients with idiopathic and iatrogenic bulbar strictures, previously treated with BMG and EPA respectively, had recurrence after Optilume and opted for repeat DCB dilation. Average time between DCB treatments was 464 days in these two patients. DCB dilation resulted in a freedom from reintervention rate of 89% in our cohort.</p><p><strong>Conclusions: </strong>DCB dilation was effective for treatment of urethral stricture recurrence after urethroplasty at a median follow-up of 228 days in our cohort. This minimally invasive intervention may be an option for patients who are not ideal surgical candidates or refuse repeat urethroplasty. Data on longer-term outcomes in this cohort is needed and is forthcoming.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2135-2141"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065570","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":"Application and evaluation of HB&L system in the rapid diagnosis of urinary tract infection.","authors":"Xianbin Huang, Zhenglin Chang, Yueting Jiang, Yuerong Chen, Haojie Wu, Zhenfeng Song, Defeng Qi, Zhangkai Jason Cheng, Baoqing Sun","doi":"10.21037/tau-2025-107","DOIUrl":"10.21037/tau-2025-107","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are among the most prevalent bacterial infections worldwide, impacting millions annually. Traditional urine culture, the gold standard for UTI diagnosis, is associated with limitations such as lengthy culture times (24-48 hours), which can delay treatment. Additionally, the increasing prevalence of antibiotic resistance further emphasizes the need for rapid diagnostic methods to enhance clinical decision-making and reduce the unnecessary use of antibiotics. The HB&L system, developed by ALIFAX, presents a promising alternative that could potentially shorten diagnostic times, improving both treatment speed and patient outcomes. This study aims to evaluate the efficacy of the HB&L system for the rapid diagnosis of UTIs, comparing its performance with traditional urine culture methods, and to explore its feasibility and potential advantages in clinical practice.</p><p><strong>Methods: </strong>From June 2023 to February 2024, midstream urine samples were collected from 409 suspected UTI patients treated at The First Affiliated Hospital of Guangzhou Medical University. The samples were analyzed using both traditional urine culture methods and the HB&L system, with concurrent urinalysis results obtained from the same specimens. Traditional urine culture served as the reference standard to evaluate the diagnostic performance of the HB&L system and urinalysis for detecting UTIs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the agreement between the methods. The Kappa coefficient was used for statistical analysis to determine the level of concordance.</p><p><strong>Results: </strong>The HB&L system demonstrated a sensitivity of 89.77%, specificity of 96.88%, PPV of 88.76%, NPV of 97.19%, and a Kappa coefficient of 0.86, indicating a high degree of concordance with traditional culture methods. In contrast, the Kappa coefficients for urinalysis parameters were 0.11 for protein, 0.08 for leukocyte esterase, and 0.44 for nitrite. The combined Kappa coefficient for these three infection-related urinalysis indicators was 0.11. The HB&L system provides results within 4.5 hours, whereas traditional methods typically require 24-48 hours. Overall, the diagnostic performance of urinalysis was inferior to that of the HB&L system.</p><p><strong>Conclusions: </strong>The HB&L system has significant advantages in the rapid and accurate diagnosis of UTIs, making it a potential alternative or complement to traditional urine culture methods.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2346-2357"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065512","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":"Efficacy of extracorporeal shock wave therapy for female stress urinary incontinence: a systematic review and meta-analysis.","authors":"Tianlong Xi, Mingchen Jin, Xiaoli Gao","doi":"10.21037/tau-2025-123","DOIUrl":"10.21037/tau-2025-123","url":null,"abstract":"<p><strong>Background: </strong>Stress urinary incontinence (SUI) significantly impacts women's quality of life. Extracorporeal shock wave therapy (ESWT) has emerged as a promising non-invasive treatment option. This systematic review and meta-analysis evaluates the efficacy of ESWT in treating female SUI.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang databases from their inception to January 2024 using 'extracorporeal shock wave', 'Low Intensity Extracorporeal Shock Wave Therapy' and 'stress urinary incontinence'. Randomised controlled trials (RCTs) and clinical studies comparing ESWT with control groups for SUI treatment were included. The primary outcomes included International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) scores and treatment efficacy. Secondary outcomes included Incontinence Impact Questionnaire-7 (IIQ-7), Overactive Bladder Symptom Score (OABSS) and Urogenital Distress Inventory (UDI) scores.</p><p><strong>Results: </strong>Four studies involving 287 patients met the inclusion criteria. The ESWT method significantly improved ICIQ-SF scores [standardised mean difference (SMD) =-4.22, 95% confidence interval (CI): -6.71 to -1.73, I²=96.6%] equating to approximately 3.8 raw score points, exceeding the established minimal clinically important difference of 2.5 points and thus representing a clinically meaningful improvement. The method also demonstrated better treatment efficacy (risk ratio =0.30, 95% CI: 0.11-0.77, I²=0%). Significant improvements were also observed in OABSS (SMD =-1.88, 95% CI: -3.51 to -0.38, I²=91.2%). However, changes in IIQ-7 and UDI scores showed no statistical significance.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that ESWT is an effective treatment for SUI, significantly improving symptoms and quality-of-life measures. The evidence suggests that ESWT is a promising non-invasive option for SUI, particularly for patients seeking non-invasive alternatives to surgery. However, high heterogeneity among studies indicates the need for larger, well-designed RCTs to further validate these findings.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2185-2194"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065617","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":"See more, do less?-resident-reported training trends in reconstructive urology.","authors":"Kevin Neuzil, Eric Wallen, John R Potts, Molly E DeWitt-Foy","doi":"10.21037/tau-2025-55","DOIUrl":"10.21037/tau-2025-55","url":null,"abstract":"<p><strong>Background: </strong>Urologic surgical training has been dramatically affected by numerous practice changes including a significant increase in robotic surgery, rise of subspecialty fellows, and even the coronavirus disease 2019 (COVID-19) pandemic, among others. How resident training has been affected is not well understood. In this study, we aim to describe the changes in resident-reported case log data for reconstructive urology surgeries, specifically for female reconstructive cases.</p><p><strong>Methods: </strong>Data were obtained from the Accreditation Council for Graduate Medical Education (ACGME) reporting system, which compiles resident-submitted case reports of procedures performed and resident role. Submitted surgeries are categorized by type using Current Procedural Terminology (CPT) codes as well as resident-reported role in the procedure-\"surgeon\", \"assistant\", \"teaching assistant\", or \"all roles\". Data from graduating urologic residents from 2010 to 2022 were reviewed.</p><p><strong>Results: </strong>From 2010 to 2022, we observed an increase in \"all roles\" reconstructive urologic cases logged by residents (0.82 cases per year, P=0.06). Reconstructive cases logged as \"surgeon\" decreased by 0.77 cases per year (P=0.057), while \"assistant\" cases increased by 1.48 cases per year (P<0.001). For female reconstructive cases, \"surgeon\" reported cases declined by 1.1 cases annually (P<0.001) while \"assistant\" role increased by 0.32 (P<0.001).</p><p><strong>Conclusions: </strong>Over the last decade, we observed a decrease in resident-reported role as \"surgeon\" in female reconstructive cases while the overall volume of reconstructive urologic cases simultaneously increased. Understanding these trends is essential for resident educators, while further research is necessary to identify potential causes.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2358-2364"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065415","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":"Review of the role of paclitaxel urethral balloon dilation for initial treatment of newly diagnosed short bulbar strictures.","authors":"Chandler Hudson, Tiffany L Damm, M Francesca Monn","doi":"10.21037/tau-2024-756","DOIUrl":"10.21037/tau-2024-756","url":null,"abstract":"<p><p>Anterior urethral stricture disease represents a significant burden of disease for adult men and remains challenging to treat without definitive open surgery in the form of urethroplasty, which requires specialized training. Many patients, particularly outside of metropolitan centers, can struggle to access reconstructive urologists for definitive repair. Endoscopic interventions-dilation, direct vision internal urethrotomy, and traditional urethral balloon dilation (UBD)-are standard first line therapy for urethral strictures, but these endoscopic interventions have high rates of recurrence. Adjuvant therapies such as mitomycin and steroids have been studied and utilized to improve endoscopic interventions with varying success. The novel paclitaxel drug coated balloon for UBD has been reported to have significantly lower recurrence rates of urethral strictures when compared with traditional endoscopic interventions. This is evidenced by randomized control trial data for 1 through 5 years post intervention. Current American Urological Association (AUA) guidelines recommend reserving the use of drug coated UBD for recurrent short anterior urethral strictures; however, these balloons are increasingly being utilized by reconstructive and general urologists in the primary setting due to the significant improvement in recurrence free survival. Herein, the authors evaluate the historical progression of endoscopic interventions and discuss the existing data for use of drug coated balloons in the primary setting.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2398-2404"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065417","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":"Development of a prognostic risk model for predicting biochemical recurrence-free survival in patients with prostate cancer based on lysine acetylation.","authors":"Bin Cao, Huijun Chen, Luting Zhang, Fang Xiao, Qiaoting Liu, Lizhen Tang, Tao You, Qiufang Ouyang","doi":"10.21037/tau-2025-179","DOIUrl":"10.21037/tau-2025-179","url":null,"abstract":"<p><strong>Background: </strong>Lysine acetylation plays a critical role in prostate cancer (PCa) by modulating androgen receptor (AR) signaling. However, the exact mechanisms by which lysine acetylation impacts PCa prognosis remain unclear. The aim of this study was to investigate the mechanism by which lysine acetylation affects PCa prognosis by modulating the AR signaling pathway.</p><p><strong>Methods: </strong>Data from The Cancer Genome Atlas-Prostate Adenocarcinoma (TCGA-PRAD), GSE54460, and lysine acetylation-related genes (LARGs) were obtained from public databases and literature. Differentially expressed genes (DEGs) were identified in TCGA-PRAD, and key module genes associated with LARGs were selected using weighted gene co-expression network analysis (WGCNA). Candidate genes were identified by overlapping DEGs and key module genes. A biochemical recurrence-free (BCR-free) prognostic model was constructed and validated using BCR-free survival data from patients with PCa. Prognostic genes were further confirmed through machine learning. PCa samples were stratified into high- and low-risk subgroups based on the median risk score. A nomogram model was developed integrating clinicopathological features and risk scores to identify independent prognostic factors. Enrichment analysis, tumor microenvironment profiling, and drug sensitivity assessments were performed for the two risk subgroups.</p><p><strong>Results: </strong>A total of 2,658 DEGs and 723 key module genes were analyzed, yielding 105 overlapping candidate genes. Five genes-<i>UBXN10</i>, <i>ACOX2</i>, <i>PLCL1</i>, <i>PLS3</i>, and <i>SLIT3</i>-were identified as BCR-free-related prognostic markers in TCGA-PRAD. The prognostic risk model revealed significantly lower BCR-free survival rates in the high-risk subgroup compared to the low-risk subgroup. A nomogram incorporating Gleason score, tumor stage (T stage), and risk score effectively predicted BCR-free survival in patients with PCa. Notably, natural killer (NK) cells, myeloid dendritic cells, endothelial cells, and fibroblasts were significantly correlated with PLS3 (|Cor| >0.3, P<0.05). Drugs such as cisplatin, MK-1775, and ulixertinib were identified as potential therapeutic agents for PCa.</p><p><strong>Conclusions: </strong>Five BCR-free-related prognostic genes were identified as potential therapeutic targets. Additionally, a BCR-free-related prognostic risk model was developed, offering a robust tool for predicting BCR-free survival in patients with PCa.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2218-2234"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065631","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":"Expression profile of small nucleolar RNAs (snoRNAs) in penile cancer.","authors":"Jaqueline Diniz Pinho, Gyl Eanes Barros Silva, Wanderley da Costa Silva, Eldevan da Silva Barbosa, Antonio Augusto Lima Teixeira-Júnior, Amanda Marques de Sousa, José Ribamar Rodrigues Calixto, Syomara Pereira da Costa Melo, Rommel Rodriguez Burbano, André Salim Khayat, Carolina Rosal Teixeira de Souza","doi":"10.21037/tau-24-305","DOIUrl":"10.21037/tau-24-305","url":null,"abstract":"<p><strong>Background: </strong>The role of small nucleolar RNAs (snoRNAs) has been investigated in the carcinogenesis of several malignancies; however, their function in penile cancer (PeCa) has not been reported. In this context, the study aimed to identify the expression profile of snoRNAs in the clinicopathological features of PeCa.</p><p><strong>Methods: </strong>This cross-sectional observational study examined the expression profile of snoRNAs in eight patients diagnosed with PeCa and four patients with phimosis (used as controls) using the GeneChip Array, correlating it with clinicopathological characteristics. Human papillomavirus (HPV) identification was performed using nested polymerase chain reaction (PCR). <i>In silico</i> analysis was conducted to characterize snoRNAs and assess their influence on the therapeutic approach for tumor types in other regions.</p><p><strong>Results: </strong>Two hundred and seventy snoRNAs showed differential expression between the studied groups, with the majority being overexpressed. In the Venn diagram, SNORD78 and SNORD46 had their expression identified exclusively in samples with perineural invasion and lymph node metastasis, respectively. SNORD13F was the least expressed (fold change =-10.41), while SNORD43 was the most overexpressed (fold change =9.79). <i>In silico</i> analysis revealed that SNORA70 and SNORA38 were associated with a reduced therapeutic response to commonly used antineoplastic drugs in PeCa.</p><p><strong>Conclusions: </strong>Despite the need to confirm the expression of these molecules in a larger number of samples and using another methodology, we suggest that these snoRNAs may serve as diagnostic, prognostic, and treatment biomarkers in PeCa.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2142-2152"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065648","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":"Modulators of urinary pH in the context of urinary stone disease: a literature review.","authors":"Carter Chan, Wilson Sui, Matthew C Breeggemann, Marshall Stoller","doi":"10.21037/tau-2025-275","DOIUrl":"10.21037/tau-2025-275","url":null,"abstract":"<p><strong>Background and objective: </strong>Urinary pH is an important factor in the preventative management of kidney stones. A variety of options are available for modulating urinary pH, including pharmaceuticals, over the counter (OTC) formulations [such as stone specific OTCs, complementary and alternative medicines (CAMs), and home remedies], and dietary modifications. These options can be overwhelming for both providers and patients and vary with regards to cost, convenience, and efficacy. In the absence of a consolidated central source of information for patients and physicians to reference, our study aims to summarize and analyze the effectiveness of these various treatment approaches to provide a more comprehensive understanding of how common interventions alter urinary pH.</p><p><strong>Methods: </strong>The PubMed database was used to identify human clinical trials related to pharmacologic and dietary interventions to modify urinary pH. Eligible studies were selected based on the following criteria: (I) observational or interventional study; (II) urinary pH as a reported outcome of the study intervention; (III) inclusion baseline or control urinary pH data; (IV) sufficient presentation of data for analytical purposes. Data was abstracted, and the mean changes in urinary pH for each intervention were compiled and grouped.</p><p><strong>Key content and findings: </strong>A total of 86 studies met inclusion criteria: 61 were randomized clinical trials, 20 were crossover or prospective studies, and 5 were observational cohort reports. In total, 150 individual experiments with a combined sample size of 2,895 were included. For urinary alkalinization, the most effective pharmaceutical, OTC formulation, and dietary change were sodium bicarbonate, Citro-Soda^®, and lacto-ovo-vegetarian diet, respectively. For urinary acidification, the most effective interventions were ammonium chloride, methionine, and high protein diet, respectively.</p><p><strong>Conclusions: </strong>Our study found that pharmaceuticals are not the only effective options for altering urine pH; select dietary changes and OTC options are also viable for patients. When considering cost, accessibility and side effects, these alternative options may be more appealing to some patients, potentially improving adherence compared to pharmaceuticals.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2428-2438"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065658","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":"A scoping review of the role of heritability and environmental exposures in the development and severity of benign prostatic hyperplasia.","authors":"Seyedeh Sima Daryabari, Kiarad Fendereski, Matthew D Grimes, Kelli X Gross, Stephen Summers, Joemy M Ramsay, Jeremy B Myers","doi":"10.21037/tau-2025-342","DOIUrl":"10.21037/tau-2025-342","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a common condition among aging men, significantly affecting quality of life and contributing to a substantial healthcare burden. The pathogenesis of BPH is strongly influenced by genetic factors, with heritability estimates showing a wide range from 20% to 83%. Emerging evidence also highlights the critical role of environmental exposures, including endocrine-disrupting chemicals (EDCs), in BPH risk, progression, and therapeutic response. This review synthesizes current knowledge on genetic and environmental determinants of BPH pathogenesis, severity, and management.</p><p><strong>Methods: </strong>A scoping review of the literature was conducted using the databases PubMed, Scopus, and Web of Science. Relevant studies on genetic predisposition, environmental exposures, and their contributions to BPH were analyzed. Data from epidemiological studies, genome-wide association studies (GWAS), familial aggregation analyses, and research on environmental exposures were integrated to provide an understanding of these factors and BPH pathogenesis.</p><p><strong>Results: </strong>Familial clustering indicates a significantly elevated risk, particularly among first-degree male relatives. Key genetic determinants include androgen receptor (<i>AR</i>) gene CAG repeat polymorphisms, where shorter repeats are linked to increased AR activity and prostate enlargement. Estrogen pathway genes, such as <i>ESR1</i> and <i>CYP19A1</i>, and variants in dihydrotestosterone (DHT) synthesis genes, notably <i>SRD5A2</i>, influence disease progression and risk. GWAS have identified additional loci, such as <i>MSMB</i> and <i>TERT</i>, associated with prostate volume and aggressive BPH phenotypes. Polygenic risk scores offer promising applications in identifying individuals at high risk for severe BPH. Environmental exposures, particularly to EDCs such as bisphenol A (BPA), bisphenol S (BPS), and bisphenol AF (BPAF), were found to disrupt hormonal regulation, contributing to prostatic hyperplasia. Air pollution, primarily particulate matter, exacerbates prostate inflammation and hyperplasia, with regional differences in BPH symptom severity correlating with air quality. Lifestyle factors, including high-fat diets and sedentary behaviors, further modulate disease severity.</p><p><strong>Conclusions: </strong>The development and progression of BPH are shaped by a complex interplay of genetic and environmental factors. EDCs contribute significantly to prostatic hyperplasia, while heritable factors influence disease onset, severity, and response to treatment. Integrating genetic risk profiling and environmental exposure assessments into clinical practice holds the potential to enhance BPH management and personalized therapeutic strategies.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2439-2455"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065473","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}