Urologia Internationalis最新文献

{"title":"Comparative Laser Efficacy and Clinical Outcomes of Pulsed Thulium:YAG versus Standard Holmium:YAG Lithotripsy.","authors":"Yusuke Shirasu, Takashi Yoshida, Yutaro Oku, Shogo Murakami, Gen Kawa","doi":"10.1159/uin/aewag005","DOIUrl":"10.1159/uin/aewag005","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to compare the efficacy and clinical outcomes of ureteroscopic lithotripsy using the holmium:YAG laser (Ho:YAG) and pulsed thulium:YAG laser (p-Tm:YAG: RevoLix HTL, LISA Laser Products, Germany) for upper urinary tract stones.</p><p><strong>Methods: </strong>This retrospective single-center study included patients who underwent ureteroscopy for kidney or ureteral stones between August 2023 and August 2025. Patients with bilateral stones, concomitant procedures, stones ≥20 mm, or without preoperative computed tomography imaging were excluded. Endpoints included operative time, laser efficacy (ratio of cumulative stone volume to operative time), and the stone-free rate (SFR).</p><p><strong>Results: </strong>We analyzed 104 patients (Ho:YAG, n = 54; p-Tm:YAG, n = 50). The p-Tm:YAG group exhibited significantly shorter operative time (46.0 vs. 66.5 min, p < 0.001) and higher laser efficacy (0.237 vs. 0.175 mm3/min, p = 0.016). Subgroup analysis revealed that p-Tm:YAG exhibited significantly shorter operative times (49.0 vs. 96.0 min, p < 0.001) and superior laser efficacy (0.252 vs. 0.183 mm3/min, p = 0.008) for stones measuring 10-20 mm, whereas similar outcomes were observed for stones <10 mm between the two groups. The Ho:YAG and p-Tm:YAG groups exhibited similar SFRs on postoperative day 1 (79.6% vs. 88.0%, p = 0.182) and at 1 month (87.0% vs. 92.0%, p = 0.325).</p><p><strong>Conclusion: </strong>Both lasers achieved comparable and high SFRs for stones <20 mm. However, the p-Tm:YAG laser offers higher laser efficacy and significantly shorter operative times, particularly for larger stones (10-20 mm), supporting its use as an efficient alternative to the Ho:YAG laser.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115396","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":"Urinary pH and Checkpoint Inhibitor Outcomes in Advanced Urothelial Carcinoma: An Exploratory Brief Report.","authors":"Satoshi Yamamoto, Manabu Kanasugi, Tomoki Shirafuji, Hiroki Bamba, Sanji Kanaoka, Kazuyoshi Nakamura","doi":"10.1159/uin/aewag031","DOIUrl":"10.1159/uin/aewag031","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary pH is a low-cost host-related marker, but its association with immune checkpoint inhibitor outcomes in advanced urothelial carcinoma is uncertain.</p><p><strong>Methods: </strong>We retrospectively reviewed 45 consecutive patients with advanced urothelial carcinoma who received pembrolizumab or avelumab and had urinary pH measured at treatment initiation. Baseline urinary pH was categorized as ≥6.5 or <6.5. Outcomes were objective response rate (ORR), progression-free survival (PFS), and overall survival. Cox models were adjusted for Bellmunt risk score. Early urinary pH dynamics were examined when available.</p><p><strong>Results: </strong>Baseline urinary pH was ≥6.5 in 20 patients and <6.5 in 25. Objective response rate was 40.0% versus 16.0%, respectively. Baseline urinary pH ≥6.5 was associated with longer PFS after Bellmunt adjustment (hazard ratio, 0.39; 95% CI, 0.17-0.86), whereas the association with overall survival was weaker. Among 32 patients with early urinary pH data, ORR was 41.7% in the high-high group, 28.6% in the low-high group, and 0% in the low-low group. In a pembrolizumab-only sensitivity cohort, the direction of association with real-world PFS was preserved but attenuated.</p><p><strong>Conclusion: </strong>Urinary pH showed an exploratory association with checkpoint inhibitor outcomes. Because urinary pH is influenced by renal function, infection, medication, hydration, and diet, it should be interpreted as a hypothesis-generating host-related signal rather than a direct surrogate of tumor acidity.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081275","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":"Effects of Pelvic Floor Pilates Training Across Age Groups in Patients with Post-Prostatectomy Incontinence.","authors":"Jianxia Wang, Di An","doi":"10.1159/uin/aewag026","DOIUrl":"10.1159/uin/aewag026","url":null,"abstract":"<p><strong>Introduction: </strong>Post-prostatectomy incontinence (PPI) is a common complication that significantly affects quality of life. Pelvic floor muscle training is a standard treatment, but the influence of age on recovery remains unclear. This study evaluated the effects of pelvic floor Pilates training across age groups among patients with PPI.</p><p><strong>Methods: </strong>A total of 48 patients were included in this 8-week prospective cohort study. Patients were stratified into three age groups: group A (<60 years), group B (60-70 years [A11.1]), and group C (>70 years). Outcomes were assessed using the 1-h pad test, the number of incontinent episodes, the International Consultation on Incontinence Questionnaire (ICIQ-SF), and the Oxford Grading Scale.</p><p><strong>Results: </strong>Significant improvements were observed in all groups. In the 1-h pad test (g), mean urine loss decreased from 80.13 ± 7.34 g to 33.75 ± 4.62 g in group A, from 81.24 ± 7.24 g to 39.53 ± 4.94 g in group B, and from 82.73 ± 6.56 g to 44.07 ± 4.56 g in group C (all p < 0.01). The number of incontinence episodes decreased from 10.38 ± 1.45 to 3.68 ± 0.70 in group A, from 10.71 ± 1.68 to 4.00 ± 0.71 in group B, and from 10.60 ± 1.40 to 4.40 ± 0.73 in group C (all p < 0.01).</p><p><strong>Conclusion: </strong>Pelvic floor Pilates training significantly improves urinary continence in patients with PPI. However, recovery appears to be influenced by age, with greater improvement observed in younger patients.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081261","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":"Intraoperative Factors Associated with de novo Overactive Bladder after Holmium Laser Enucleation of the Prostate.","authors":"Kyohei Watanabe, Atsushi Otsuka, Yoshihiro Tsuchiya, Gaku Ishikawa, Asuka Sano, Ayana Takemura, Ryota Aki, Shunsuke Watanabe, Yuto Matsushita, Hiromitsu Watanabe, Keita Tamura, Daisuke Motoyama, Teruo Inamoto","doi":"10.1159/uin/aewag028","DOIUrl":"10.1159/uin/aewag028","url":null,"abstract":"<p><strong>Introduction: </strong>HoLEP markedly attenuates symptoms in the majority of patients with BPH. However, a subset develops de novo OAB postoperatively, which may significantly compromise QOL. Despite its clinical relevance, evidence regarding the incidence of and perioperative factors contributing to de novo OAB after HoLEP remains limited.</p><p><strong>Methods: </strong>The present study included 536 patients who underwent HoLEP between April 2013 and September 2023. Among them, 175 patients without preoperative OAB were eligible for analysis.</p><p><strong>Results: </strong>De novo OAB was identified in 18 of 175 patients (10.3%). Baseline demographic and preoperative characteristics did not significantly differ between the groups. Intraoperatively, patients who developed de novo OAB exhibited shorter enucleation times, whereas the durations of other intraoperative procedures were significantly longer. Postoperatively, IPSS-QOL scores were significantly higher in the de novo OAB group, indicating impaired satisfaction, while voiding function parameters were similar between the groups.</p><p><strong>Conclusions: </strong>Approximately 10% of patients developed de novo OAB following HoLEP, leading to impaired postoperative QOL even when postoperative voiding function parameters were similar between the groups. Intraoperative factors, particularly prolonged hemostasis and endoscopic manipulation at the bladder neck, may be associated with this risk. These results suggest that intraoperative factors may be associated with the development of de novo OAB after HoLEP.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064654","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":"Comment on: \"Chest CT in Testicular Mass Evaluation: A Stepwise Approach to Minimize Radiation Exposure\" - Clarifying Algorithm Development, Validation, and Clinical Implementation.","authors":"Emrah Küçük, Muhammed Esad Kayhan, Mücahid Uğur","doi":"10.1159/uin/aewag030","DOIUrl":"10.1159/uin/aewag030","url":null,"abstract":"","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002633","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":"Adjustable Transobturator Male System in Artificial Urinary Sphincter Patients: A Good Alternative?","authors":"Marc Kidess, Elisa Lederer, Troya Georgieva, Julian Hermans, Leo F Stadelmeier, Marina Hoffmann, Nikolaos Pyrgidis, Julian Marcon, Philipp Weinhold, Patrick Keller, Michael Chaloupka, Benedikt Ebner, Daniel Puhr-Westerheide, Ricarda M Bauer, Christian G Stief, Yannic Volz","doi":"10.1159/uin/aewag023","DOIUrl":"10.1159/uin/aewag023","url":null,"abstract":"<p><strong>Introduction: </strong>Post-prostatectomy stress urinary incontinence (SUI) significantly impairs patients' quality of life. While the artificial urinary sphincter (AUS) is considered the gold standard for managing severe SUI, a subset of patients is not suitable for this intervention. This study aimed to evaluate the clinical outcomes of patients who received an adjustable transobturator male system (ATOMS) as an alternative to AUS for the treatment of SUI.</p><p><strong>Methods: </strong>In this single-center retrospective study, we included 25 patients who received ATOMS implantation for post-prostatectomy SUI, despite being technically eligible for AUS based on incontinence severity and pelvic floor status. Primary outcomes included pad usage, continence rates, complications, and patient-reported satisfaction. A cross-sectional follow-up was conducted using standardized questionnaires.</p><p><strong>Results: </strong>Median age was 74.0 years; 60% of patients had undergone pelvic radiotherapy. Preoperative median pad usage was 6.0/day, reduced to 3.0/day postoperatively. Social continence (≤1 pad/day) was achieved in 16% and ≥50% reduction in pad usage in 76% of patients. Complications were mostly minor. Cross-sectional follow-up data were available for 60% of patients at a median of 42 months. Patient satisfaction was high (73.3%), and 80% would recommend the procedure. According to the PGI score, 73.3% reported \"very much\" or \"much improved\" outcomes.</p><p><strong>Conclusion: </strong>ATOMS represents a feasible and safe treatment alternative for patients with severe SUI who are unable or unwilling to undergo AUS implantation. Despite suboptimal continence outcomes compared to AUS, high satisfaction and acceptable complication rates support its use in appropriately selected patients.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897872","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":"Comparative Analysis of the Safety and Efficacy of Endoscopy-Assisted Supine Percutaneous Nephrolithotomy versus Standard Supine Percutaneous Nephrolithotomy: A Randomized Prospective Study.","authors":"Joshgun Huseynov, Deniz Noyan Özlü, Feyzi Arda Atar, Ali İhsan Taşçı","doi":"10.1159/uin/aewag022","DOIUrl":"10.1159/uin/aewag022","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to compare the safety and efficacy of endoscopy-assisted supine percutaneous nephrolithotomy (ePNL) with standard supine percutaneous nephrolithotomy (sPNL).</p><p><strong>Methods: </strong>This study included patients aged over 18 with a stone size of ≥2 cm, an American Society of Anesthesiologists score of ≤3, and a body mass index of ≤35 who underwent ePNL or sPNL at our hospital between January 2021 and August 2021. Eligible patients, selected based on inclusion and exclusion criteria, were randomized using a computer-generated random table. Perioperative and postoperative data were compared between the two groups.</p><p><strong>Results: </strong>A total of 60 patients were included in the study. Demographic data and stone characteristics were similar between the groups. The access fluoroscopy time was comparable between the groups; however, the total fluoroscopy time (TFT) was significantly shorter in the ePNL group (31.5 s vs. 197.5 s, p < 0.0001). The amount of bleeding, assessed by hemoglobin drop, was higher in the sPNL group (p = 0.03). The success rate of guidewire placement into the ureter after access was higher in the supine ePNL group compared to the sPNL group (66.6% vs. 36.6%, p = 0.038). There was no statistically significant difference in overall complication rates between the groups (p = 0.272). Stone-free rates were 86.6% for ePNL and 80% for sPNL (p = 0.488).</p><p><strong>Conclusion: </strong>The ePNL method is a safe and effective technique characterized by less bleeding, shorter fluoroscopy time, and successful guidewire placement into the ureter, with similar success and complication rates to sPNL.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897889","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":"Pelvic Lymph Node Dissection at Radical Prostatectomy: Patterns of Failure and Decision Impact.","authors":"Steffen Lebentrau, Ingmar Wolff, Christian Gilfrich, Matthias May","doi":"10.1159/uin/aewag025","DOIUrl":"10.1159/uin/aewag025","url":null,"abstract":"","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897921","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":"Postoperative Care after Transurethral Resection (Transurethral Resection of the Prostate and Transurethral Resection of Bladder Tumour): Early Mobilization, Activity Restriction, and Convalescence - A Scoping Review.","authors":"Patrick Betschart, Jessica Rührup, Mark Meier, Alberto Piller, Thomas Leippold, Carlo Camathias","doi":"10.1159/uin/aewag021","DOIUrl":"10.1159/uin/aewag021","url":null,"abstract":"<p><strong>Background: </strong>Transurethral resection of the prostate (TURP), transurethral resection of bladder tumour, and laser-based alternatives (holmium laser enucleation of the prostate, thulium laser enucleation) account for a substantial share of urological procedures worldwide. Patients are routinely advised to restrict physical activity postoperatively to reduce secondary haemorrhage, yet recommendations vary widely, conflate two distinct clinical phases - immediate mobilization (hours to days) and medium-term convalescence (weeks) - and their evidence base has not been systematically examined.</p><p><strong>Summary: </strong>This PRISMA Extension for Scoping Reviews (PRISMA-ScR) scoping review searched PubMed, Scopus, Embase, and <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link> (June 1, 2026), with a supplementary search (July 2026) targeting urinary tract infection, orchitis/epididymitis, anticoagulation, and frailty. Of 263 records identified, 31 sources were charted (5 directly relevant, 26 contextual); the supplementary search added 10 contextual sources. No trial compared activity restriction with early mobilization using surgical complication endpoints. No data linked activity level to urinary tract infection or orchitis/epididymitis after transurethral resection. Enhanced recovery after surgery (ERAS) studies incorporating early mobilization showed improved or unchanged recovery without increased complications. All direct evidence addresses the immediate postoperative phase; no study examined medium-term convalescence restrictions as a defined intervention. Frailty, comorbidities, and anticoagulation are clinically relevant risk modifiers but remain unstudied in relation to postoperative activity.</p><p><strong>Key messages: </strong>(1) Direct evidence comparing activity restriction with early mobilization after transurethral resection using surgical endpoints is absent. (2) ERAS data support early mobilization within multimodal bundles as feasible and safe. (3) Current recommendations conflate immediate mobilization with medium-term convalescence; future research should address each phase separately. (4) Patient-level factors - frailty, comorbidities, and anticoagulation status - should inform individualized activity recommendations. (5) A focused randomized trial with bleeding, infectious, and return-to-activity endpoints is the research priority.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897929","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":"Sex-Specific Impact of Neurogenic Lower Urinary Tract Dysfunction on Quality of Life: A Cross-Sectional Study.","authors":"Jürgen Pannek, Jasmin Lea Mahler, Jens Wöllner, Jörg Krebs","doi":"10.1159/uin/aewag013","DOIUrl":"10.1159/uin/aewag013","url":null,"abstract":"<p><strong>Introduction: </strong>The assessment of neurogenic lower urinary tract dysfunction (NLUTD) should include objective and quality of life (QoL) measures, considering sex and gender differences. Thus, we investigated the sex-specific impact of NLUTD on QoL.</p><p><strong>Methods: </strong>We evaluated consecutive outpatients with chronic NLUTD, who had completed the Short Form (SF)-Qualiveen questionnaire from September 2024 to January 2026 at a specialized spinal cord injury center, in a cross-sectional study. Patient characteristics and urodynamic parameters were retrieved from patient charts. Treatment success and risk for renal damage were determined based on urodynamic data. The effects of sex, age, bladder evacuation method, urinary incontinence, urinary tract infections, and treatment success on SF-Qualiveen overall and domain scores were analyzed.</p><p><strong>Results: </strong>Data of 113 patients (48 females, 65 males) were analyzed. Mean age was 60.6 ± 12.9 years in females and 61.2 ± 12.4 years in males. Mean NLUTD duration was 21.8 ± 15.1 years in females and 22.1 ± 16.9 years in males. In most patients, NLUTD treatment was successful (77.0%), and no risk for renal damage was present (89.4%). The median overall SF-Qualiveen score was 1.125 (0.625/1.844). There were no significant (p > 0.11) differences between the sexes in the different QoL scores. Only urinary incontinence had a significant (p = 0.04) effect on QoL scores. Patients with urinary incontinence had a significantly (p = 0.01) greater overall QoL score (median 1.75, 1.125/2.125) compared to those without incontinence (median 1.0, 0.625/1.5).</p><p><strong>Conclusion: </strong>In patients with adequately treated NLUTD, there were no sex-specific differences in QoL. However, urinary incontinence had a negative impact on QoL.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875624","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}