Translational andrology and urology最新文献

{"title":"Clinical value of spontaneous cavernous activity evaluation in identifying misdiagnosed corporal venous occlusive dysfunction in psychogenic erectile dysfunction.","authors":"Zizhou Meng, Haowei Bai, Shiyun Liu, Erlei Zhi, Ruhui Tian, Chencheng Yao, Peng Li, Yuhua Huang, Huixing Chen, Fujun Zhao, Bangmin Han, Shujie Xia, Zheng Li, Huirong Chen","doi":"10.21037/tau-2025-174","DOIUrl":"10.21037/tau-2025-174","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have indicated that corporal venous occlusive dysfunction (CVOD) may be misdiagnosed in some patients with psychogenic erectile dysfunction (ED), as the observed venous leakage could actually reflect cavernous smooth muscle (CSM) relaxation failure due to sympathetic overactivity. Misdiagnosed CVOD can lead to inappropriate treatment decisions, such as unnecessary penile venous surgery or reliance solely on phosphodiesterase type 5 inhibitors (PDE5i), overlooking the need for psychogenic interventions. Therefore, it is important to identify the misdiagnosis of CVOD. Corpus cavernosum electromyography (CC-EMG) offers unique insights into the autonomic and myogenic integrity of CSM. This retrospective analysis aimed to evaluate the clinical value of spontaneous cavernous activity (SCA) assessment in identifying misdiagnosed CVOD in psychogenic ED.</p><p><strong>Methods: </strong>The study enrolled 168 ED patients who underwent comprehensive evaluation using color duplex Doppler ultrasound (CDDU) and CC-EMG-based SCA assessment (amplitude and duration). Psychogenic ED was confirmed through nocturnal penile tumescence and rigidity (NPTR) monitoring. CVOD patients identified by CDDU were stratified into two subgroups based on NPTR results: psychogenic ED group (misdiagnosed CVOD) and organic ED group (actual CVOD).</p><p><strong>Results: </strong>The cohort comprised 69 cases (41.1%) of non-vascular ED (NVED), 67 cases (39.9%) of CVOD, 15 cases (8.9%) of arterial ED (AED), and 17 cases (10.1%) of mixed ED (MED). Among CVOD patients, 30 cases were classified as misdiagnosed CVOD and 37 as actual CVOD. Comparative analysis demonstrated that the SCA parameters were significantly higher in the misdiagnosed CVOD group compared to those of the actual CVOD group, with notable differences in amplitude (305.65±196.79 <i>vs.</i> 172.07±86.36 µV, P=0.002) and duration (3.31±1.94 <i>vs.</i> 2.36±1.26 s, P=0.046). Receiver operating characteristic (ROC) curve analysis demonstrated an area under the curve (AUC) of 0.666 [P=0.02, 95% confidence interval (CI): 0.503-0.830] for SCA amplitude, with an optimal cutoff of 357.50 µV yielding 94.7% specificity and 55.0% sensitivity, indicating its potential predictive value for identifying misdiagnosed CVOD in psychogenic ED.</p><p><strong>Conclusions: </strong>The findings suggested that elevated SCA may contribute to CVOD development in psychogenic ED through impaired CSM relaxation due to sympathetic overactivity. SCA assessment might be a useful diagnostic tool for identifying misdiagnosed CVOD in psychogenic ED. However, given the modest AUC, along with high specificity but low sensitivity of SCA parameters for diagnosing misdiagnosed CVOD, further research is needed to identify additional clinical parameters with better predictive performance.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1691-1700"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675775","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":"Does neoadjuvant chemotherapy and radical cystectomy in muscle-invasive bladder cancer obliterate survival differences between genders?","authors":"Gina Sidiqi, Hanna Stauch, Markus Johansson, Farhood Alamdari, Oskar Lidén, Ylva Huge, Firas Aljabery, Johan Svensson, Amir Sherif","doi":"10.21037/tau-2024-699","DOIUrl":"10.21037/tau-2024-699","url":null,"abstract":"<p><strong>Background: </strong>The 5-year survival rate in muscle-invasive bladder cancer (MIBC) is approximately 50%, cross over computed tomography (CT) stage in chemo-naive patients. Studies indicate lower survival rates in females when compared to males. The theories that explain the sex disparity are hormonal factors and delayed diagnosis for females. New investigations suggest that neoadjuvant chemotherapy (NAC) might be a possible method for bridging the gender survival gap. The aim of this study was to investigate whether complete treatment with NAC (≥3 cycles) prior to cystectomy reduces the gender gap in survival rates for MIBC and improves the surrogate marker of downstaging.</p><p><strong>Methods: </strong>A multicenter retrospective cohort from five Swedish urological centers, from 1st January 2005 to 17th July 2023 based on NAC-eligible patients divided in NAC-receiving and non-NAC-receiving subgroups and further divided by sex (males and females). Survival was analyzed based on the Kaplan-Meier method, using log-rank test and adjusted analyses were made with the Cox regression model. Outcome measurements were overall survival (OS), disease-free survival (DFS), and downstaging.</p><p><strong>Results: </strong>In the analysis of the total cohort (n=412), we could not detect any statistically significant differences in OS between NAC and non-NAC, nor between sexes, in the unadjusted analysis. In the adjusted analysis, we did not observe any significant differences in OS between sexes, either in total or within the NAC subgroups. Further analyzing the NAC group, we could see a significant increased downstaging rate in the NAC group compared to the non-NAC group (P<0.001) which indicates an increased survival in those receiving NAC treatment. There was no relationship between sexes and downstaging (P=0.72). Neither could we see any significant difference in downstaging between males and females in the NAC/non-NAC subgroups (P=0.41 and P=0.92, respectively).</p><p><strong>Conclusions: </strong>NAC-eligible female and male MIBC patients who underwent radical cystectomy (RC) after at least three cycles of NAC, demonstrated similar OS and DFS. NAC seems to obliterate survival differences between genders in MIBC patients.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1589-1600"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675777","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":"Interpretable machine learning driven biomarker identification and validation for prostate cancer.","authors":"Jianxu Yuan, Dalin Zhou, Shengjie Yu","doi":"10.21037/tau-2025-242","DOIUrl":"10.21037/tau-2025-242","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa), a common malignancy among men globally, requires the identification of biomarkers for early diagnosis and predicting progression. This study aimed to identify the key genes involved in the occurrence and development of PCa.</p><p><strong>Methods: </strong>Leveraging data from the Gene Expression Omnibus (GEO) database, this study integrated multi-chip datasets, conducting differential expression analysis and enrichment analysis to pinpoint PCa-related genes. Subsequently, machine learning models were constructed using least absolute shrinkage and selection operator (LASSO) regression, support vector machine (SVM), and random forest (RF) methods. The optimal model was selected for further study and the contribution of related genes was explained using SHapley Additive exPlanations (SHAP) analysis. Furthermore, gene set enrichment analysis (GSEA) and immune cell infiltration analysis were utilized to uncover the underlying molecular mechanisms.</p><p><strong>Results: </strong>In this study, 222 differentially expressed genes (DEGs) were identified and found to be enriched in functions and pathways potentially associated with PCa. Using multiple machine learning models, eight PCa-related core genes (<i>TRPM4</i>, <i>EDN3</i>, <i>EFCAB4A</i>, <i>FAM83B</i>, <i>PENK</i>, <i>NUDT10</i>, <i>KRT14</i>, and <i>CXCL13</i>) were identified. The most accurate RF model was selected for further study with SHAP analysis, which also revealed the contribution of the above genes. GSEA and immune cell infiltration analysis uncovered distinctions between PCa and normal tissues.</p><p><strong>Conclusions: </strong>This study offered potential biomarkers and a theoretical basis for the diagnosis and treatment for PCa.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1528-1541"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675786","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 call for evidence-based strategies in artificial urinary sphincter erosion management.","authors":"Ariel Zisman, Nicola Fazaa, Kamil Malshy","doi":"10.21037/tau-2025-246","DOIUrl":"10.21037/tau-2025-246","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1839-1841"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675798","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 novel autologous material for the surgical treatment of Peyronie's disease: the outer plate of the prepuce.","authors":"Xiaowei Hu, Xiaoxiao Fan, Chaoxia Qian, Cheng Fang, Zhipeng Xu","doi":"10.21037/tau-2025-200","DOIUrl":"10.21037/tau-2025-200","url":null,"abstract":"<p><strong>Background: </strong>Peyronie's disease (PD), a connective tissue disease, is characterized by the formation of fibrous lesions or plaques in the tunica albuginea. Many PD patients rely on surgical treatment methods. This study aimed to investigate the feasibility of using the outer plate of the prepuce to repair the defect of the corpus cavernosum after plaque enucleation in patients with PD.</p><p><strong>Methods: </strong>The defect of the corpus cavernosum in eleven patients with PD [lateral curvature (n=4), dorsal curvature (n=6), and both dorsal and lateral curvature (n=1)] was repaired using the outer plate of the prepuce. The penile lengths of the patients before and after the operation were measured. The International Index of Erectile Function-5 (IIEF-5) questionnaire score was determined and RigiScan (nocturnal penile tumescence and rigidity mode) was performed before and 3 months after the operation. The patient underwent intracavernous injection (ICI) and color Doppler duplex ultrasound (CDDU) examinations before the operation to rule out the presence of vascular erectile dysfunction (ED).</p><p><strong>Results: </strong>All eleven patients with PD could maintain the physiological penile erection after the operation. In the early stage, only one patient experienced numbness and hypoesthesia, which resolved after 3 months. The recurrence of penile deformity and induration was low. All patients were sexually competent with both patients and their sexual partners reporting improved satisfaction. The penile length of the patient after the operation (9.55±1.34 minutes) was shorter than that before the operation (12.00±1.55 minutes). The IIEF-5 score at month 3 post-operation was 22.73±0.79 points, which was higher than that before the operation (22.09±0.70 points) (P>0.05). RigiScan revealed that the duration of the erectile hardness, which was greater than 60%, at month 3 post-operation (12.76±1.12 minutes) was higher than that before surgery (12.04±1.61 minutes) (P>0.05). The peak systolic velocity and end-diastolic volume before the operation were 42.83±5.27 and 0.13±0.75 cm/s, respectively.</p><p><strong>Conclusions: </strong>The toughness and ductility of the outer plate of the prepuce are conducive to repairing the corpus cavernosum defect and mitigating the foreign body sensation and rejection reaction in patients with PD.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1566-1574"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675799","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":"Testosterone threshold, assay and costs among laboratories for hypogonadism diagnosis.","authors":"Hector Rodrigo Gonzalez-Carranza, Abraham Morgentaler, Luis Antonio Reyes-Vallejo","doi":"10.21037/tau-2025-162","DOIUrl":"10.21037/tau-2025-162","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of testosterone deficiency (hypogonadism) requires documentation of low testosterone concentration. Despite the thresholds for low testosterone established by various guidelines, non-expert physicians rely on reference ranges provided by laboratories. The objective of this study was to determine the consistency of laboratory-established reference ranges for total testosterone (TT) among Mexico City clinical laboratories.</p><p><strong>Methods: </strong>Information was requested from 202 laboratories in Mexico City in August 2024. The items of interest included the TT reference ranges, equipment, assays, and costs.</p><p><strong>Results: </strong>The responses were obtained from 134 laboratories. There were 27 different sets of reference ranges used in this study. The high TT threshold ranged from 400 to 1,719 ng/dL (variability: 487%), whereas the lower limit ranged from 84 to 470 ng/dL (variability: 426%). Five measurement methods were described, and the most frequently used was chemiluminescence 69 (51.11%), followed by electrochemiluminescence 25 (18.65%). The cost ranged from $9-160 USD, with a mean of $35 USD.</p><p><strong>Conclusions: </strong>The extreme variability in laboratory-established TT reference ranges represents a major challenge for the appropriate diagnosis and management of men with symptomatic testosterone deficiency. Although these results were obtained in Mexico City, there is good reason to believe that this problem exists globally.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1759-1764"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675808","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":"Global epidemiological trends in prostate cancer burden: a comprehensive analysis from Global Burden of Disease Study 2021.","authors":"Xi Lin, Yi Zhi","doi":"10.21037/tau-2025-103","DOIUrl":"10.21037/tau-2025-103","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PC) remains a major global health concern, with significant geographic and ethnic disparities in incidence and mortality. While the widespread use of prostate-specific antigen screening has improved early detection, ongoing debates regarding overdiagnosis and overtreatment raise concerns about its clinical utility and cost-effectiveness. Previous studies have examined regional variations in disease burden, yet gaps persist in understanding long-term epidemiological trends and the influence of sociodemographic factors. A standardized, comprehensive analysis is essential to guide evidence-based prevention and control strategies. This study investigated PC incidence, mortality, prevalence, and disability-adjusted life years (DALYs) between 1990 and 2021, providing a detailed assessment of its global burden. By analyzing temporal and regional trends, this study seeks to inform targeted prevention efforts and optimize healthcare resource allocation.</p><p><strong>Methods: </strong>Data were analyzed for annual incident cases, deaths, prevalence, DALYs, age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs), and age-standardized prevalence rates (ASPRs) for PC from 1990 to 2021, using data from the Global Burden of Disease (GBD) Study 2021. Temporal trends were assessed by calculating percentage changes in incident cases, deaths, and DALYs, along with estimated annual percentage changes (EAPCs) in ASIR, ASDR, ASPR, and DALYs. Pearson correlation analyses were conducted to evaluate the relationship between EAPCs and the socio-demographic index (SDI). Joinpoint regression was applied to identify significant shifts in these metrics over time.</p><p><strong>Results: </strong>The analysis reveals a 161.53% increase in global PC incidence and a 0.568% rise in prevalence, while mortality rates have declined by 0.83%. Regional variations are evident, with Eastern Europe and South Asia experiencing a higher burden of disease. Age distribution analysis shows that PC predominantly affects older populations, particularly individuals aged 70 years and above. SDI analysis indicates a positive correlation between SDI and PC prevalence, while the association with DALYs is comparatively weaker. Additionally, high-income regions such as Bermuda, Antigua, and Barbuda exhibit significant disparities in disease burden.</p><p><strong>Conclusions: </strong>PC remains a growing global burden with significant regional and age-related disparities. While higher SDI regions show increased prevalence, the weaker correlation with DALYs suggests that healthcare access alone does not fully alleviate disease burden. These findings emphasize the need for targeted strategies that integrate early detection with equitable treatment and long-term management to reduce disparities and improve outcomes.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 5","pages":"1238-1252"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318000","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 time to prevent infectious complications is now: why transperineal prostate biopsies should be the new gold standard worldwide.","authors":"Christopher Orf, Joachim Noldus, Sebastian Berg","doi":"10.21037/tau-2025-50","DOIUrl":"10.21037/tau-2025-50","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 5","pages":"1147-1149"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318017","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":"Age-related changes in lncRNA expression in sperm.","authors":"Qiao Zhou, Guangyao Li, Hui Ji, Juan Ji, Zhonghui Ling, Jingwen Sun, Hui Ding, Junqiang Zhang, Xiufeng Ling, Xiaoning Chen, Lu Xu","doi":"10.21037/tau-2025-31","DOIUrl":"10.21037/tau-2025-31","url":null,"abstract":"<p><strong>Background: </strong>Over the past few decades, the age of parenthood has become increasingly delayed. With increasing age, offspring health may be affected; these effects can include an increased risk of genetic disorders and diseases related to neurodevelopment and cognitive function, such as autism and schizophrenia. Long noncoding RNAs (lncRNAs) play important roles in reproductive processes and epigenetics, regulating gene expression through epigenetic modifications, transcriptional regulation, and posttranscriptional control. Abnormal lncRNA expression is associated with the occurrence of various diseases. Currently, no research on alterations in the lncRNA expression profile in sperm from older fathers is available. This study aims to investigate the changes in lncRNA expression profiles in sperm from older fathers and explore their potential impact on offspring health.</p><p><strong>Methods: </strong>A total of six volunteers were included; three volunteers (≥40 years old) were assigned to the study group, and the remaining volunteers (<40 years old) were assigned to the control group. High-throughput sequencing was used to analyze lncRNA and messenger RNA (mRNA) expression in sperm samples.</p><p><strong>Results: </strong>The analysis revealed significant differences in the expression of 8,154 lncRNAs between the two groups: these lncRNAs consisted of 4,031 downregulated lncRNAs and 4,123 upregulated lncRNAs. In addition, 2,930 significantly differentially expressed mRNAs were identified; among these mRNAs, 1,155 were upregulated, and 1,775 were downregulated. Functional enrichment analysis of the differentially expressed lncRNAs and mRNAs revealed roles in pathways such as metabolism, RNA transport, and protein hydrolysis. Through comprehensive analysis of the lncRNA-mRNA network, we constructed a network of 178 co-expressed lncRNAs and mRNAs.</p><p><strong>Conclusions: </strong>Spermatogenesis is a complex biological process (BP) regulated by various factors, including lncRNAs. This study provides preliminary data to help understand changes in lncRNA expression in the sperm of older fathers and may provide insight for future research on the health of offspring from older fathers.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 5","pages":"1408-1417"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317979","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":"GreenLight photoselective laser vaporisation versus transurethral resection of the prostate for large prostates: systematic review and meta-analysis.","authors":"Breno C Porto, Bianca C Benedicto, Beatriz T Constantinou, Nathalie C Hobaica, Carlo C Passerotti, Richard Dobrucki de Lima, Rodrigo A S Sanderberg, Everson L A Artifon, Jose P Otoch, Jose A S da Cruz","doi":"10.21037/tau-2025-111","DOIUrl":"10.21037/tau-2025-111","url":null,"abstract":"<p><strong>Background: </strong>Transurethral resection of the prostate (TURP) stands as a primary surgical intervention for benign prostatic hyperplasia (BPH), although laser techniques, notably photoselective vaporisation of the prostate (PVP), are gaining traction. Previous studies have already assessed the efficacy of TURP and PVP, although with small prostates (<70 mL). Thus, this systematic review and meta-analysis aims to assess the efficacy of PVP compared to TURP in the male BPH population with large prostates (≥70 mL).</p><p><strong>Methods: </strong>A systematic review was conducted across MEDLINE, Embase, Scopus, Web of Science, and Google Scholar. Studies comparing PVP to TURP in male BPH patients were included. Our primary outcome was the International Prostate Symptom Score (IPSS). Secondary outcomes encompassed maximum urinary flow rate (Qmáx), postvoid residual volume (Vres), operative time, catheterization time, postoperative hospital stay and complications. To assess the risk of bias we used Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomized studies, and risk of bias 2 tool (Cochrane) (RoB2) for the randomized.</p><p><strong>Results: </strong>Three articles encompassing 159 patients each in the PVP and TURP groups were included. Our analysis revealed no statistically significant difference in IPSS score between PVP and TURP [mean difference (MD) 1.56; 95% confidence interval (CI): 0.52 to 3.64; P=0.14; I²=85%]. TURP demonstrated a reduced operative time (MD 30.35; 95% CI: 11.26 to 49.44; P=0.002; I²=96%), whereas PVP exhibited shorter catheterization time (MD -2.22; 95% CI: -2.44 to -1.99; P<0.001; I²=1%) and postoperative hospital stay (MD -2.20; 95% CI: -2.69 to -1.72; P<0.001; I²=75%). No significant differences were observed in other outcomes assessed.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that PVP is non-inferior to TURP concerning IPSS, Qmáx, Vres, and complications, albeit with a longer operative time. PVP showed a reduced catheterization and postoperative hospital stay.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 5","pages":"1261-1272"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318001","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}