Urologia Internationalis最新文献

{"title":"Upper Urinary Tract Urothelial Carcinoma Diagnosis Effect on Life Expectancy Relative to Population-Based Controls: A Retrospective Analysis.","authors":"Carolin Siech, Mario de Angelis, Letizia Maria Ippolita Jannello, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Fred Saad, Shahrokh F Shariat, Salvatore Micali, Nicola Longo, Ottavio de Cobelli, Alberto Briganti, Mike Wenzel, Philipp Mandel, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz","doi":"10.1159/000548236","DOIUrl":"10.1159/000548236","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to examine 5-year overall survival (OS) of upper urinary tract urothelial carcinoma (UTUC) patients versus age- and sex-matched population-based controls.</p><p><strong>Methods: </strong>Within Surveillance, Epidemiology, and End Results database (2004-2020), we identified newly diagnosed (2004-2015) UTUC patients. Relying on Social Security Administration Life Tables (2004-2020), age- and sex- matched population-based controls were simulated (Monte Carlo simulation).</p><p><strong>Results: </strong>Of 10,140 UTUC patients, 3,984 (39%) exhibited localized, 4,904 (49%) locally advanced, and 1,252 (12%) metastatic stages. At 5 years of follow-up, the OS rate was 41 versus 78% (Δ 37%) in UTUC patients versus controls. According to stage, OS difference was greatest in metastatic stage (4 vs. 75%; Δ 71%), followed by locally advanced (36 vs. 78%; Δ 42%) and localized stages (58 vs. 78%; Δ 20%). At 5 years of follow-up, the CSM rate was 44%, and the OCM rate was 16%. According to stage, CSM and OCM rates were 88 and 7% in metastatic, 49 and 15% in locally advanced, and 22 and 19% in localized stage UTUC patients.</p><p><strong>Conclusion: </strong>UTUC patients may experience worse OS compared to population-based controls. The most pronounced differences in the 5-year OS were recorded in metastatic and locally advanced stages, suggesting a potentially substantial impact of UTUC on patients' life expectancy.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-10"},"PeriodicalIF":1.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Gentamicin Prophylaxis in Robot-Assisted Prostatectomy Increases Acute Kidney Injury Risk.","authors":"Michael Glietsch, Simon Blaschke, Anke Lux, Gernot Geginat, Martin Schostak","doi":"10.1159/000548188","DOIUrl":"10.1159/000548188","url":null,"abstract":"<p><strong>Introduction: </strong>Aminoglycosides, valued for their lower antimicrobial resistance, are used for perioperative antibiotic prophylaxis (PAP) in urological procedures such as robot-assisted radical prostatectomy (RARP). However, data regarding the safety of gentamicin in robot-assisted surgery remain limited. This study assessed the incidence of acute kidney injury (AKI) associated with PAP with single-dose gentamicin during the transition from open prostatectomy to RARP.</p><p><strong>Methods: </strong>This single-center, retrospective, matched case-control study included 77 RARP patients receiving gentamicin and 72 matched controls receiving cefuroxime. AKI was assessed using the Kidney Disease: Improving Global Outcome (KDIGO) criteria, considering age, comorbidities, and prostate weight.</p><p><strong>Results: </strong>AKI occurred in 33.8% of the gentamicin group versus 9.7% of the cefuroxime group, resulting in an odd's ratio (OR) of 6.25. In the gentamicin group, grade 1 AKI was most frequent (19.5%), followed by grade 2 (7.8%) and grade 3 (6.5%). In the cefuroxime group, grades 1 (5.6%) and 2 (4.2%) were observed. Prostate volume and gentamicin use emerged as independent cofactors. Limitations include missing long-term data, variable gland measurements, and inclusion of patients with pre-existing kidney disease.</p><p><strong>Conclusion: </strong>The risk of AKI was significantly higher after PAP with gentamicin compared to PAP with cefuroxime (OR: 6.25, 95% CI: 2.095-18.664, p = 0.001), suggesting that PAP with gentamicin should be avoided in RARP.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Neoadjuvant Hormone Therapy Combined with Radical Prostatectomy in Improving Oncological Outcomes for Patients with cT3 Prostate Cancer: A Systematic Review and Meta-Analysis.","authors":"Hua Luo, Gaoyuan Liao, Yanghan Liu","doi":"10.1159/000547875","DOIUrl":"10.1159/000547875","url":null,"abstract":"<p><strong>Introduction: </strong>This comprehensive review and meta-analysis investigates the effectiveness of neoadjuvant hormone therapy (NHT) in conjunction with radical prostatectomy (RP) for patients diagnosed with clinical stage T3 (cT3) prostate cancer (PCa) patients. Our objective is to evaluate its influence on cancer-related outcomes.</p><p><strong>Methods: </strong>In accordance with PRISMA standards, we conducted an analysis of 10 randomized controlled trials (RCTs) sourced from PubMed, Embase, Web of Science, and Cochrane databases, with a cutoff date of May 17, 2025. The main outcomes assessed included rates of positive surgical margins (PSMs) rates and prostate-specific antigen progression-free survival (PSA-PFS). Additional outcomes evaluated were pathologic complete response (pCR), minimal residual disease (MRD), and metastasis-free survival (MFS). We aggregated risk ratios (RRs), hazard ratios (HRs), and mean differences along with 95% confidence intervals (CI) utilizing either fixed or random-effects models.</p><p><strong>Results: </strong>The combination of NHT and RP led to a notable decrease in PSM rates when compared to RP alone (RR = 0.75, 95% CI: 0.60-0.94, p = 0.01), particularly evident in Asian demographics (RR = 0.47, p = 0.001) and for NHT durations of 6 months or more (RR = 0.75, p = 0.01). Additionally, PSA-PFS showed significant enhancement (HR = 0.25, 95% CI: 0.22-0.28). While there was no overall advantage in achieving pCR or MRD, certain subgroups in North America and those undergoing extended NHT experienced benefits. MFS did not show any significant changes (RR = 0.99, 95% CI: 0.89-1.10).</p><p><strong>Conclusion: </strong>The combination of NHT and RP enhances immediate surgical and biochemical results in patients with cT3 PCa, especially among those of Asian descent, and leads to a longer duration of NHT. However, the long-term survival advantages are still not established, highlighting the need for standardized RCTs to refine treatment protocols.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-20"},"PeriodicalIF":1.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Intrarenal Pressure Monitoring during Endourological Procedures for Stone Disease: A Canary in the Coalmine for Optimizing Patient Safety.","authors":"Naeem Bhojani, Larry E Miller, Samir K Bhattacharyya, Wei Jin Chua, Thomas Tailly, Brian Eisner, Ben H Chew","doi":"10.1159/000547874","DOIUrl":"10.1159/000547874","url":null,"abstract":"<p><strong>Background: </strong>Ureteroscopy is a widely used minimally invasive procedure for treating kidney stones. While ureteroscopy is generally safe and effective, it carries risks of complications that may be associated with elevated intrarenal pressure (IRP) during the procedure. This paper discusses the importance of monitoring and managing IRP during endourological procedures to mitigate the risk of complications.</p><p><strong>Summary: </strong>We conducted a review on IRP during endourological procedures, combining systematic and narrative approaches, to examine complications, clinical implications, and IRP monitoring practices. Preclinical and clinical studies have demonstrated strong associations between elevated IRP during endourological procedures and complication risk. Further, cumulative IRP exposure, which considers pressure magnitude and duration, may be a stronger predictor of complication risk than mean or peak IRP values alone. Surveys indicate that while many urologists acknowledge the clinical importance of monitoring and managing IRP, there remains a lack of awareness of real-time IRP monitoring technologies that can alert surgeons to elevated pressures and prompt immediate procedural modifications to mitigate complication risks.</p><p><strong>Key messages: </strong>Based on current evidence, IRP monitoring should be considered for patients at high risk for pressure-related complications during endourological procedures, which includes a significant proportion of the patient population due to the prevalence of risk factors such as older age, female sex, diabetes mellitus, and obesity. A coordinated effort across the urological community is recommended to generate additional high-quality data to further our understanding of the potential benefits of real-time monitoring technologies.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Erectile Dysfunction and Obstructive Sleep Apnoea and the Impact on Severity of ED following Treatment of OSA: A Systematic Review.","authors":"Zain Ahmed Siddiqui, Daniel Peter McNicholas, Adam Spacey, Ian Pearce, Vaibhav Modgil","doi":"10.1159/000546690","DOIUrl":"10.1159/000546690","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction is a debilitating condition defined as the inability to achieve or maintain penile erection sufficient for satisfactory sexual activity. Obstructive sleep apnoea is a common sleep disorder resulting in episodes of intermittent hypoxia experienced by the patient. It has been hypothesized that a link between both conditions exists. This systematic review aims to evaluate the current literature and synthesize the evidence linking erectile dysfunction and obstructive sleep apnoea, the possible pathogenesis involved, and potential treatment options available.</p><p><strong>Methods: </strong>This is a mixed-method systematic review and narrative synthesis reporting qualitative and quantitative data. The databases MEDLINE, PubMed, and Embase were searched between January 2000 and January 2022.</p><p><strong>Results: </strong>Eighteen studies were included, comprising 5 randomized controlled trials, 11 prospective studies, and 2 cross-sectional studies. The literature has reported up to 82% prevalence of ED in patients with OSA. Studies investigating the role of CPAP in treating ED in this cohort of patients have shown results varying from no significant effect to complete resolution of ED.</p><p><strong>Conclusion: </strong>There does appear to be an association between the presence of OSA and ED. Further randomized controlled trials to evaluate the efficacy of CPAP on ED in patients with OSA need to be conducted. Until more robust evidence is available, CPAP is a safe treatment likely to improve symptoms in individuals with OSA. However, the degree to which it may affect ED symptoms is not yet clear, but what appears clear is that it does not negatively impact on erectile function and is most likely to offer some degree of improvement.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-10"},"PeriodicalIF":1.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Posterior Fornix Syndrome Is an Important Differential Diagnosis for Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Peter Emanuel Petros, Maren Juliane Wenk, Bernhard Liedl, Klaus Goeschen, Jacob Bornstein","doi":"10.1159/000547785","DOIUrl":"10.1159/000547785","url":null,"abstract":"<p><strong>Background: </strong>The catalyst for this analysis was a statement by Dr. Magnus Fall at a meeting of invited experts in 2020 of IC/BPS (interstitial cystitis/bladder pain syndrome): \"A paradigm shift in the understanding of IC/BPS is urgent.\" This review analyses such a paradigm shift.</p><p><strong>Summary: </strong>The paradigm shift began with the serendipitous cure of Hunner's lesion in a woman with a diagnosis of posterior fornix syndrome (PFS) and uterine prolapse. Retrospective analysis of surgical data from eight PFS studies reporting pain and urge cure found PFS was consistent with IC/BPS definitions. No Hunner's lesions/ulcers were reported in the eight studies. Anatomical pathways for urge/frequency were consistent with Tanagho's descriptions of normal micturition (albeit prematurely activated); pathways for abnormal emptying/retention were consistent with inability of pelvic muscles to open the posterior urethral wall prior to micturition; pathways for pelvic pain were consistent with de novo impulses from pelvic visceral plexuses caused by unsupported USLs (uterosacral ligaments).</p><p><strong>Key messages: </strong>As PFS and IC/BPS have similar symptoms, USL repair of prolapse can potentially deliver improvement/cure for urge and pain symptoms, provided diagnostic PFS criteria (e.g., speculum test) for PFS are met. Two hypotheses explain inflammatory end-organ responses observed in Hunner's IC/BPS and offer new research directions.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-10"},"PeriodicalIF":1.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Insights: Balancing Diagnostic Benefits and Oncological Risks of Ureteroscopic Biopsy before Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma.","authors":"Lucas Bohn, Mousa Nofal, Stephan Ledderose, Gerald B Schulz, Robert Bischoff, Philipp Maximilian Kazmierczak, Michael Chaloupka, Jozefina Casuscelli, Raphaela Waidelich, Christian G Stief, Severin Rodler, Lennert Eismann, Benedikt Ebner","doi":"10.1159/000547508","DOIUrl":"10.1159/000547508","url":null,"abstract":"<p><strong>Introduction: </strong>The role of diagnostic ureteroscopy (URS) prior to radical nephroureterectomy (RNU) remains controversial due to concerns about an increased risk of intravesical recurrence (IVR). However, existing studies frequently exhibit two major confounders: lack of reporting on the use of mitomycin C instillation after RNU and not excluding patients with a history of bladder cancer.</p><p><strong>Methods: </strong>We retrospectively evaluated the proportion of RNU patients for whom preoperative URS biopsy results were decisive for therapeutic decision-making. The impact of URS biopsy on IVR, overall survival (OS), and cancer-specific survival (CSS) was evaluated using univariate and multivariable Cox regression analyses and Kaplan-Meier curves.</p><p><strong>Results: </strong>Between January 2005 and November 2022, 229 patients with upper tract urothelial carcinoma (UTUC) underwent RNU with single postoperative mitomycin C instillation at our department. After excluding those with a history of bladder cancer, 148 RNU patients were included in the final analysis (prior URS biopsy: 125 [84%], no URS biopsy: 23 [16%]). Before RNU, both urine cytology and CT were inconclusive in 37% of patients. URS biopsy confirmed UTUC in 73% of these cases. Univariate and multivariable Cox regression analyses revealed no significant differences in IVR, OS, or CSS between patients who underwent URS biopsy before RNU and those who did not.</p><p><strong>Conclusion: </strong>URS biopsy was essential for clinical decision-making in one-third of patients who underwent RNU. There were no oncologic disadvantages for patients who underwent URS biopsy prior to RNU, demonstrating its utility in clinical practice without compromising oncologic outcomes.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Kidney Injury Causes Chronic Kidney Disease Progression after Partial Nephrectomy: A Retrospective Study Identifying Patients at Risk.","authors":"Sebastian Kälble, Simon Udo Engelmann, Maximilian Haas, Christoph Pickl, Christoph Eckl, Emily Rinderknecht, Christopher Goßler, Renate Pichler, Francesco Del Giudice, Peter J Siska, Bernhard Banas, Maximilian Burger, Franz Josef Putz, Roman Mayr","doi":"10.1159/000547649","DOIUrl":"10.1159/000547649","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess parameters predicting acute kidney injury (AKI) and chronic kidney disease progression (CKDP) after partial nephrectomy (PN).</p><p><strong>Methods: </strong>The data of 785 patients were retrospectively reviewed. Follow-up eGFR was assessed in 542 patients. Patient characteristics, comorbidities, medication, and type of surgery were analyzed using group comparison and logistic regression.</p><p><strong>Results: </strong>Age (OR: 1.027 95% CI: 1.008-1.047; p = 0.006), male sex (OR: 2.128 95% CI: 1.506-3.007; p < 0.001), anemia (OR: 2.423 95% CI: 1.521-3.858; p < 0.001), CKD (OR: 1.742 95% CI: 1.084-2.800; p = 0.022), open PN (OR: 3.190 95% CI: 1.958-5.198; p < 0.001), ischemia (WIT) (OR: 1.049 95% CI: 1.027-1.072; p < 0.001), and surgery time (OR: 1.005 95% CI: 1.001-1.008; p = 0.008) were independent predictors of AKI. CKDP occurred in 224 (41.3%) patients, of whom 137 (61.2%) had experienced AKI (p < 0.001). Incidence increased with each AKI stage, which was the only independent predictor of CKDP (OR: 2.391 95% CI: 1.603-3.567; p < 0.001). Patient characteristics, approach, and WIT had no significant impact on CKDP.</p><p><strong>Conclusion: </strong>AKI determines CKDP. Renal function loss increased at each AKI stage. We identified patients at risk for AKI, who could benefit from minimally invasive surgery and perioperative assessment in a team with nephrologists. As WIT did not influence CKDP, surgeons might consider prioritizing oncological outcomes, without compromising renal function through unnecessarily strict WIT limitations.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Bone Metastasis Risk in Prostate Cancer: A Three-Parameter Model Using Bone Sialoprotein, ISUP Grading, and Tumor Progression.","authors":"Christos Philippou, Simon Gloger, Burkhard Ubrig, Norman Bitterlich, Emilia Krassimirova Naseva, Hans-Joerg Sommerfeld, Andreas Wiedemann, Dirk Theegarten, Haji Abdulla, Stathis Philippou","doi":"10.1159/000547556","DOIUrl":"10.1159/000547556","url":null,"abstract":"<p><strong>Introduction: </strong>Osseous metastasis is the most common site of distant spread in prostate cancer. Several factors contribute to predicting bone metastasis, including elevated PSA levels, short PSA doubling time, advanced ISUP grading, local tumor progression, and novel biomarkers. However, no clinical scoring system currently exists to assess bone metastasis risk at the time of prostate cancer diagnosis. Furthermore, no study has investigated the correlation between predictive factors and bone sialoprotein (BSP) expression in the primary tumor.</p><p><strong>Methods: </strong>Immunohistochemistry was used to evaluate BSP expression in transrectal ultrasound-guided biopsies from prostate cancer patients. Data from 673 patients were analyzed over a 7-9 year follow-up period to assess the development of bone metastases. BSP expression was also evaluated in patients with benign prostatic hyperplasia (BPH). Additionally, BSP expression was analyzed alongside established risk factors using multivariate logistic regression to determine their combined predictive value for bone metastasis.</p><p><strong>Results: </strong>Bone metastases developed in 12.5% (84/673) of patients. BSP expression was negative (0-5%) in 23.8% of cases, while 22.2% exhibited high expression (>40%). Patients with bone metastases had significantly higher BSP expression than those without (55.5 ± 19.7% vs. 25.7 ± 24.9%; p < 0.001). In contrast, 97% of patients without prostate carcinoma had BSP values below 5%. Among metastatic patients: 82.9% had BSP expression of at least 40%, and none had values below 20%. As a single predictive parameter, BSP showed a sensitivity of 50% and a specificity of 81.6%. However, using multivariate analysis, a three-parameter scoring model integrating BSP expression, ISUP grading, and the number of affected core needle biopsies achieved 88.6% sensitivity and 81.1% specificity for predicting bone metastases.</p><p><strong>Conclusion: </strong>BSP expression serves as a potential indicator for bone metastasis development but lacks sufficient sensitivity as a standalone clinical marker. Similarly, local tumor progression and histopathologic grading (ISUP) fail as single predictors. However, integrating BSP expression with established risk factors significantly enhances predictive accuracy. Given that all three parameters are derived from routine histopathological analysis, BSP immunohistochemistry should be considered for integration into clinical practice for early risk stratification in prostate cancer patients.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Insertion of Suprapubic Catheters in Patients with Neurogenic Lower Urinary Tract Dysfunction: An Old Method Revisited.","authors":"Jürgen Pannek, Jens Wöllner","doi":"10.1159/000547509","DOIUrl":"10.1159/000547509","url":null,"abstract":"<p><strong>Introduction: </strong>Although intermittent catheterization is the gold standard for bladder evacuation in patients with neurogenic lower urinary tract dysfunction (NLUTD), an increasing number of patients are not able to perform this procedure and require indwelling catheters. Insertion of a suprapubic catheter (SPC) is usually done percutaneously. Due to comorbidities, this minimally invasive approach is not possible in all patients. We describe the results of a case series of patients in which the SPC was inserted by laparotomy.</p><p><strong>Methods: </strong>In a retrospective chart analysis, we evaluated the complication rates, clinical course, and urodynamic results in patients with NLUTD undergoing autologous SPC insertion by laparotomy at our institution.</p><p><strong>Results: </strong>The data of 24 patients who underwent this procedure could be analyzed. In 1 patient, SPC placement was not possible with this technique. After a median follow-up of 37 months, all patients were still equipped with an SPC. In 3 patients, surgical re-insertion was required. One patient used an additional transurethral catheter due to incontinence despite SPC. Postoperative complications occurred in 5 patients (20.8%), which required surgical interventions in 3 patients (12.5%) (wound revision and transurethral coagulation).</p><p><strong>Conclusion: </strong>In our case series, SPC insertion by laparotomy is a safe and well-tolerated procedure with satisfying long-term results in patients with NLUTD who otherwise would have been dependent on transurethral catheters. This technique should, thus, be considered in carefully selected patients.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-5"},"PeriodicalIF":1.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}