Translational andrology and urology最新文献

{"title":"Endoscopic buccal urethroplasty for membranous stricture disease.","authors":"Garrett N Ungerer, Sierra T Pence, Bridget L Findlay, Yeonsoo S Lee, Boyd R Viers, Katherine T Anderson, Jonathan N Warner","doi":"10.21037/tau-24-430","DOIUrl":"10.21037/tau-24-430","url":null,"abstract":"<p><p>Membranous urethral strictures pose a challenging problem for reconstructive urologists given the difficult location and the impact on continence. Our study aims to expand on the surgical technique, outcomes, and complications of endoscopic buccal mucosal urethroplasty (EBMGU) in the treatment of membranous stricture disease. A single institution retrospective review of patients treated with EBMGU for management of membranous stricture disease between February 2022 and December 2024 was conducted. Patients with obliterative strictures and radiation were also included. Data collected included patient demographics, prior treatments, uroflow, post void residual volumes, stricture characteristics, intraoperative details, and complications. Patients with at least a 4-month follow-up cystoscopy were included. Surgical success was defined as the ability to pass a 17-Fr cystoscope into the bladder at the time of 4-month follow-up. Twenty-eight men are included in this study. Median age was 71 years (range, 46-85 years), and median follow-up was 8 months (range, 4-27 months). Twenty-four (85%) had prior radiation, and 4 had a history of pelvic fracture urethral injury (PFUI). Five (17%) patients had an obliterative stricture disease, 26 (93%) patients had at least one prior intervention, 23 (82%) were patent on 4-month cystoscopy, and these patients had a history of radiation. All patients with a history of PFUI were patent on a 4-month cystoscopy. Sixteen (57%) have gone on to receive an artificial urinary sphincter (AUS), 3 (10%) patients required cystectomy with urinary diversion. One for refractory hematuria due to radiation cystitis, one for refractory symptomatic bladder neck necrosis with sloughing, and one for delayed urosymphyseal fistula in the setting of extensive radionecrosis of the bladder neck. EBMGU is an effective option for management of membranous stricture disease in radiated patients in the short term. Four-month success rates were 82%. More than half of the patients went on to successful AUS placement.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2383-2390"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065625","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":"Factors associated with erectile dysfunction in men with lower urinary tract symptoms (LUTS): a Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) study.","authors":"Devin Boehm, Abigail R Smith, Sarah A Mansfield, Kathryn E Flynn, Richard J Fantus, Alexander P Glaser, Brian T Helfand, Margaret Helmuth, Tara N Morgan, H Henry Lai, Aruna V Sarma, Claire C Yang, Ziya Kirkali, James W Griffith","doi":"10.21037/tau-2025-86","DOIUrl":"10.21037/tau-2025-86","url":null,"abstract":"<p><strong>Background: </strong>Erectile function (EF) and its associated covariates have not been extensively studied in a large covariate of patients seeking treatment for lower urinary tract symptoms (LUTS). Our objective is to determine the relationship between urinary symptoms and comorbidities with erectile dysfunction (ED) in 447 treatment-seeking men with LUTS.</p><p><strong>Methods: </strong>Data from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study were analyzed using multivariable logistic regression models to quantify the relationship between LUTS and ED. Models also included anxiety, depression, obesity, cardiovascular disease (CVD), diabetes, and medication use.</p><p><strong>Results: </strong>Men reporting sexual activity were younger (median age 61 <i>vs.</i> 69 years) and had lower prevalence of diabetes and CVD (13% and 15%, respectively) compared with men reporting no sexual activity (24% for diabetes and 27% for CVD). Among sexually-active participants, higher odds of ED were associated with diabetes [odds ratio (OR) =2.4; 95% confidence interval (CI): 1.1-5.0], age (per 5 years, OR =1.4; 95% CI: 1.2-1.6), urinary incontinence (UI) (OR =1.2; 95% CI: 1.0-1.4), and anxiety (per 10 T-score units, OR =1.4; 95% CI: 1.0-2.1). Low erectile confidence was related to older age in non-sexually-active men (per 5 years, OR =1.5; 95% CI: 1.2-1.8). In sexually-active men, anxiety (per 10 T-score units, OR =1.6; 95% CI: 1.1-2.4), age (OR =1.3; 95% CI: 1.2-1.5), PDE5-inhibitor use (OR =2.1, 95% CI: 1.0-4.3), and diabetes (OR =2.2; 95% CI: 1.1-4.7) were also associated with low erectile confidence.</p><p><strong>Conclusions: </strong>The association of UI with ED highlights the importance of screening men with UI for ED. Modifiable health variables, such as anxiety and diabetes, were related to ED and erectile confidence in treatment-seeking men with LUTS.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2207-2217"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065643","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 analysis of clinicopathological characteristics and prognostic outcomes in fumarate hydratase-deficient renal cell carcinoma versus high-grade papillary renal cell carcinoma.","authors":"Yanfei Yu, Mancheng Xia, Shengwei Xiong, Aixiang Wang, Libo Liu, Yichuan Wang, Wei Yu, Shiming He, Xuesong Li, Suxia Wang","doi":"10.21037/tau-2025-255","DOIUrl":"10.21037/tau-2025-255","url":null,"abstract":"<p><strong>Background: </strong>Papillary renal cell carcinoma (pRCC) is characterized by pronounced molecular and phenotypic heterogeneity. The traditional dichotomous classification was discontinued in the 2022 World Health Organization (WHO) Fifth Edition Classification, leading to the introduction of new renal cancer categories, including fumarate hydratase (FH)-deficient renal cell carcinoma (RCC). But there remains a significant risk of misdiagnosis between FH-deficient RCC and high-grade pRCC. Furthermore, existing studies rarely provide comprehensive comparative analyses of these types of renal cancer. This study aims to investigate the clinical and pathological characteristics, as well as the prognosis, of FH-deficient RCC and high-grade pRCC, thereby providing a basis for precise diagnosis.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical and pathological data of patients diagnosed with high-grade pRCC (n=40) or FH-deficient RCC (n=20) between May 2012 and May 2023.</p><p><strong>Results: </strong>Compared to high-grade pRCC, FH-deficient RCC exhibited significant differences in several parameters: age (P<0.001), presence of necrosis (P=0.007), sarcomatoid differentiation (P=0.03), vascular cancer thrombus formation (P=0.02), lymph node metastasis (P=0.001) renal sinus invasion (P=0.042), perirenal fat invasion (P=0.01), adrenal gland invasion (P=0.003), and pathological tumor (pT) stage (P=0.009). Patients with FH-deficient tumors tended to be younger and were more likely to exhibit features such as necrosis, sarcomatoid differentiation, renal sinus and perinephric fat invasion, adrenal gland involvement, lymph node metastasis, and more advanced pathological stages compared with those with high-grade pRCC. However, FH-deficient RCC demonstrated a significantly lower incidence of lymphovascular invasion when compared to high-grade pRCC. The 3-year progression-free survival (PFS) rates were 16.9% for FH-deficient RCC and 76.2% for high-grade pRCC. Patients with FH-deficient RCC had significantly worse outcomes than those with high-grade pRCC (P<0.001).</p><p><strong>Conclusions: </strong>Patients who are younger, have advanced pathological stages, or exhibit sarcomatoid differentiation should undergo mandatory immunohistochemical staining for FH and molecular testing to prevent misdiagnosis as conventional pRCC. Despite its aggressive local behavior and poorer clinical outcomes, FH-deficient RCC shows a significantly lower frequency of vascular invasion relative to high-grade pRCC. Further investigation into the mechanisms underlying the metastasis of these tumors is warranted to identify potential therapeutic targets.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2195-2206"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065476","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":"Urethral complications after holmium laser enucleation of the prostate are more common in patients with smaller prostates.","authors":"Madison T Taychert, Emily C Serrell, Dan Gralnek, Christopher Manakas, Margaret Knoedler, Ali Antar, Javier Santiago, Matthew D Grimes","doi":"10.21037/tau-2025-256","DOIUrl":"10.21037/tau-2025-256","url":null,"abstract":"<p><strong>Background: </strong>Holmium laser enucleation of the prostate (HoLEP) is a bladder outlet obstruction procedure used for the treatment of benign prostatic hyperplasia (BPH). While early postoperative complications and outcomes are reported, data regarding the incidence and management of delayed urethral complications (UC), including bladder neck contracture (BNC) and urethral stricture disease (USD) are limited. We aim to define the incidence and outcomes of patients with UC following HoLEP.</p><p><strong>Methods: </strong>A retrospective chart review was performed for 1,374 patients operated on between 07/2020-12/2023. We defined the occurrence of BNC or USD as requiring surgical treatment postoperatively. Current procedural terminology (CPT) codes were utilized to identify patients who underwent direct vision internal urethrotomy, cystoscopy with urethral dilation, urethroplasty, meatotomy, or incision of BNC. UC patients were compared to available patient metrics from our prospectively maintained database. Mann-Whitney tests, Fisher exact tests, and logistic regression were performed in GraphPad Prism version 10.3.1.</p><p><strong>Results: </strong>Of 1,374 patients, 20 (1.5%) had a UC postoperatively, including 14 BNC (70%), 3 USD (15%), and 3 who had both BNC and USD (15%). UC patients had significantly lower prostate volumes, surgical specimen weights, lesser enucleation and morcellation times than those without UC (P<0.05), while morcellation and enucleation efficiency were not. Logistic regression resulted in an odds ratio (OR) of 0.987 [95% confidence interval (CI): 0.974-0.997]. Presentation of UC occurred at a mean 148 days (range, 75-205 days) after surgery, with 10 (50%) of patients needing multiple surgical treatments for UC. Fifteen (75%) UC patients had a postoperative urinary tract infection (UTI) defined by presence of positive urinalysis, symptoms, and prescription of antibiotics.</p><p><strong>Conclusions: </strong>We find that UC after HoLEP occurs with a low incidence of 1.5% and is associated with smaller prostate volume. We also characterize a complicated postoperative course for these patients, marked by high UTI rates and need for multiple UC surgeries. Further investigation into potential pathophysiologic mechanisms driving the association between small prostate volume and UC after HoLEP.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2337-2345"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065487","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":"Improving patient satisfaction and anatomical fit: a retrospective study on the purse-string suture-assisted disposable circumcision suture device.","authors":"Yan Long, Tian-Chi Wang, Ke-Jian Wang, Yong Zhu","doi":"10.21037/tau-2025-324","DOIUrl":"10.21037/tau-2025-324","url":null,"abstract":"<p><strong>Background: </strong>The disposable circumcision suture device (DCSD) faces significant limitations in anatomical adaptability. We developed a novel technique integrating the adjustable purse-string suture (APSS) from proctology to address this unmet need. This study aimed to evaluate the safety and feasibility of APSS-DCSD for circumcision.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 93 consecutive patients undergoing circumcision (December 2023-January 2025). Non-randomized allocation stratified patients into: the APSS-DCSD cohort (n=45) and conventional DCSD cohort (n=48). Outcomes measure included operative time, blood loss, complications (frenular injury, infection), intraoperative pain (Visual Analogue Scale, VAS), patient satisfaction, and healing time.</p><p><strong>Results: </strong>No significant intergroup differences were observed in blood loss (median: 3.2 <i>vs.</i> 3.1 mL; P=0.66), healing time (median: 24 <i>vs.</i> 23 days; P=0.85), or VAS scores (median: 3.0 <i>vs.</i> 4.0; P=0.10). The APSS-DCSD cohort revealed longer operative times [7.0 <i>vs.</i> 6.5 min; 95% confidence interval (CI): 1.708-8.809; P<0.001] and significantly higher satisfaction (median score: 5 <i>vs.</i> 4; 95% CI: 3.414-20.995; P<0.001). Incision infections occurred in three cases overall (APSS-DCSD: 2.2% <i>vs.</i> DCSD: 4.2%; P>0.99). No severe complications (hematoma, frenular injury) were documented in either cohort.</p><p><strong>Conclusions: </strong>The APSS-DCSD approach significantly improves anatomical precision and patient satisfaction without compromising safety margins. Its standardized protocol demonstrates particular utility in complex anatomies, warranting prospective multicenter validation.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2245-2253"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065593","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":"Non-SMC condensin I complex subunit H promotes cell proliferation and inhibits cell apoptosis of clear cell renal cell carcinoma by activating the PI3K/AKT pathway.","authors":"Hualan Ha, Jieneng Wang, Xingxing Zhang, Yuelin Du, Wei Xiong, Sheng Li, Panfeng Shang","doi":"10.21037/tau-2025-197","DOIUrl":"10.21037/tau-2025-197","url":null,"abstract":"<p><strong>Background: </strong>Clear cell renal cell carcinoma (ccRCC) is a common cancer worldwide, frequently linked to unfavorable outcomes. The non-SMC condensin I complex subunit H (NCAPH) protein, one of the components of the non-structural maintenance of chromosomes (SMC) condensin I complex, plays a crucial part in regulating this complex, which is instrumental in the progression and advancement of various malignancies. Nonetheless, the significance of NCAPH in ccRCC is still not fully understood. This investigation was conducted to explore its potential impacts on ccRCC.</p><p><strong>Methods: </strong>This investigation employed publicly available resources, such as The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases, to evaluate the differential expression of NCAPH in ccRCC tumour tissues in comparison to corresponding normal tissues. Additionally, the study investigated the relationship between the prognostic model predicting overall survival (OS) and the advancement of ccRCC. An analysis was conducted on the genes expressed differently between groups with high and low NCAPH levels, followed by Gene Set Enrichment Analysis (GSEA) to gain further insights. Moreover, the presence of immune cell types within the context of NCAPH was also investigated. In addition to analyses from publicly available databases, assessments employing quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot techniques were utilized to determine the levels of expression of NCAPH in ccRCC cell lines and tissue samples. Cell lines with stable NCAPH knockdown were created to further investigate its functional role. To evaluate cell growth, colony formation assays and Cell Counting Kit-8 (CCK-8) tests were performed. The analysis of the cell cycle and apoptosis was carried out using flow cytometry. Additionally, Western blot techniques were conducted to determine the levels of expression of proteins associated with apoptosis, cell cycle regulation, and the PI3K/AKT signaling pathway.</p><p><strong>Results: </strong>An increase in NCAPH levels was observed in both tissues and cell lines derived from ccRCC. High levels of NCAPH were found to correlate with lower survival outcomes and a weakened immune response. The reduction of NCAPH levels could halt the progression of tumor cells during the G1 phase, which, in turn, greatly restricted their proliferation while promoting apoptosis. Additionally, it was shown that NCAPH could have an important role in activating the PI3K/AKT signaling pathway within ccRCC cells.</p><p><strong>Conclusions: </strong>Individuals with ccRCC who demonstrated elevated levels of NCAPH were at an increased likelihood of experiencing poor prognostic outcomes. Moreover, NCAPH was crucial for promoting cellular growth and inhibiting apoptosis by activating the PI3K/AKT signaling pathway in ccRCC, suggesting its potential utility as both a marker for prognosis and a target for therapy.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2153-2170"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065654","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":"Retrocaval ureter: a narrative review.","authors":"Sonia Pérez-Bertólez, Paula Salcedo, Leopoldo Tapia, Anna Domenech, Oriol Martín-Solé, Luis García-Aparicio","doi":"10.21037/tau-24-580","DOIUrl":"10.21037/tau-24-580","url":null,"abstract":"<p><strong>Background and objective: </strong>Retrocaval ureter is a rare congenital anomaly resulting from the abnormal development of the inferior vena cava (IVC), where the ureter passes posteriorly and loops around the IVC. This review aims to provide a comprehensive overview of the etiology, classification, clinical presentation, diagnostic approaches, and management strategies for retrocaval ureter.</p><p><strong>Methods: </strong>We performed a narrative, non-systematic literature review using PubMed, Google Scholar, Embase, and Web of Science for articles related to retrocaval ureter to perform a narrative review of the current literature on retrocaval ureter, including clinical case series, reviews, and surgical outcome studies. Emphasis was placed on diagnostic imaging, surgical techniques, and outcomes.</p><p><strong>Key content and findings: </strong>Retrocaval ureter has an estimated incidence of 1 in 1,000 births and is more frequently diagnosed in males. It is classified into two anatomical types, with Type 1 being more common and often associated with significant hydronephrosis. Advances in imaging, including computed tomography (CT) urography and magnetic resonance (MR) urography, have improved diagnostic accuracy. The management of retrocaval ureter varies depending on the severity of symptoms, but surgical correction, primarily through minimally invasive techniques like laparoscopic or robotic ureteroureterostomy, is the treatment of choice in symptomatic patients. Minimally invasive surgery offers reduced recovery time and excellent outcomes.</p><p><strong>Conclusions: </strong>Retrocaval ureter is a rare but significant condition that can lead to ureteral obstruction and hydronephrosis. Early diagnosis through modern imaging and prompt surgical intervention in symptomatic cases can prevent long-term renal damage. Minimally invasive techniques have emerged as the gold standard for surgical management, offering favorable outcomes with minimal complications.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2456-2466"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065267","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 review of management options for vesicourethral anastomotic stenosis and the emergence of robotic reconstruction.","authors":"Aurash Naser-Tavakolian, Ziho Lee","doi":"10.21037/tau-24-503","DOIUrl":"10.21037/tau-24-503","url":null,"abstract":"<p><p>Vesicourethral anastomotic stenosis (VUAS), a sequela of radical prostatectomy, is among the most complex conditions managed by reconstructive urologists. As a distinct entity from bladder neck contracture, VUAS can be managed endoscopically or with reconstruction. There is a paucity of higher-level evidence and head-to-head comparisons between VUAS management options. Interpretation of existing studies is further complicated by variations in diagnostic staging of VUAS, definitions of recurrent VUAS, and criteria for post-procedural success. Multiple endoscopic approaches are available including dilation, transurethral incision, transurethral resection, intralesional injections, and endoscopic urethroplasty. Classically, reconstruction for VUAS is offered after a single failed attempt at endoscopic management. Reconstructive options include transperineal reconstruction, open abdominopelvic reconstruction, and robotic-assisted surgical techniques. In recent years, several advances in reconstruction have developed into minimally invasive techniques using multi- and single-port robotics. Early outcomes of robotic reconstructive surgery demonstrate excellent rates of treatment success and, compared to open approaches, notably lower rates of <i>de novo</i> urinary incontinence. Both endoscopic and surgical treatment of VUAS present significant risks of morbidity including the potential need for urinary diversion, therefore appropriate patient counseling and shared decision-making are critical prior to urologic intervention.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2405-2418"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065392","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":"Prevention and management of difficult ureteroscope withdrawal caused by ureteroscopic impaction: a narrative review.","authors":"Feng Yin, Hongtai Tu, Hongmin Chen, Tianxiang Xie, Junrong Zou, Rihai Xiao","doi":"10.21037/tau-2025-208","DOIUrl":"10.21037/tau-2025-208","url":null,"abstract":"<p><strong>Background and objective: </strong>Among the complications of ureteroscopic lithotripsy, withdrawal difficulties due to ureteroscopic impaction have not been well studied. Most of the existing literature is limited to single-center retrospective analysis or small-sample case reports. The purpose of this article is to elucidate the causes of intraoperative ureteroscopic impaction, summarize relevant research evidence, and propose effective prevention and management strategies.</p><p><strong>Methods: </strong>Through a systematic search of PubMed and Web of Science spanning from 1999 to 2024, English and Chinese literature containing keywords such as \"ureteroscopy\", \"difficult ureteroscope withdrawal\", \"ureteroscopic impaction\", and \"ureteral injury\" were included. The search covered retrospective studies, case reports, and experimental studies.</p><p><strong>Key content and findings: </strong>This review identified that the primary causes of ureteroscopic impaction encompass operator-related factors, instrumental characteristics, ureteral anatomical strictures, pathological strictures, and ureteral spasms. Preventive strategies involve comprehensive preoperative assessment, appropriate ureteroscopy selection, and meticulous procedural technique. Regarding management, mild cases may resolve spontaneously with observation, whereas severe impaction necessitates employment of specialized exit techniques.</p><p><strong>Conclusions: </strong>This review offers clinicians comprehensive strategies for preventing and managing ureteroscopic impaction, which can help reduce surgical risks and improve patient outcomes. Further multicenter, prospective studies are necessary to optimize relevant technologies and methods in the future.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2419-2427"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064839","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":"The high-risk factors of urinary infectious stones: a retrospective study.","authors":"Cheng Tang, Chengmeng Liu, Weimin Jiang, Xing Zhou, Guang Yang, Yong Xu","doi":"10.21037/tau-2025-244","DOIUrl":"10.21037/tau-2025-244","url":null,"abstract":"<p><strong>Background: </strong>Urinary stones are a common condition with increasing prevalence worldwide. Predicting the type of urinary stones is essential for guiding treatment, yet complex imaging models are not always accessible. This study aims to identify simpler clinical predictors and explore the risk factors for infected urinary stones using statistical and receiver operating characteristic (ROC) analyses.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 1,067 patients with urinary stones who underwent surgical treatment between 2018 and 2023. Patients were classified into infected and non-infected stone groups based on stone composition. Logistic regression analysis adjusted for age, gender, body mass index (BMI), and serum electrolytes was performed to identify significant predictors, with sensitivity analyses using inverse probability weighting (IPW) to address cohort imbalance. The predictive performance of key factors was assessed using ROC curves.</p><p><strong>Results: </strong>Of the total cohort, 686 (64.3%) had infectious stones, and 381 (35.7%) had non-infectious stones. Infectious stones were more common in females, younger patients, and those with ureteral stones. Preoperative urine cultures revealed <i>Proteus mirabilis</i> (24.3%) and <i>Escherichia coli</i> (18.2%) as predominant pathogens. Multivariate analysis identified three independent predictors for infectious stones: alkaline urine pH [hazard ratio (HR) 2.54, 95% confidence interval (CI): 1.33-4.88, P<0.001], ureteral stone location (HR 5.60, 95% CI: 2.38-13.17, P<0.001), and absence of diabetes mellitus (HR 4.74, 95% CI: 1.50-15.03, P=0.01). Sensitivity analyses confirmed robustness (adjusted HRs: 2.49, 5.58 and 4.65, respectively). Among these, ureteral stone location had the best predictive performance [area under the curve (AUC) =0.782, sensitivity 84.0%, specificity 71.5%], followed by urine pH (AUC =0.766, sensitivity 79.3%, specificity 68.7%), while diabetes status showed weaker predictive ability (AUC =0.623).</p><p><strong>Conclusions: </strong>Alkaline urine pH and ureteral stone location are strong predictors of infected urinary stones, while diabetes status is less predictive. These findings highlight the importance of integrating simple clinical parameters to improve the preoperative assessment and management of patients with urinary stones, particularly in resource-limited settings.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2171-2184"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065480","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}