Urology最新文献

{"title":"Use of an enuresis alarm to guide timing of post-void residual volume assessment in infants and medically-complex, non-verbal children.","authors":"Peter Y Cai, Andrea Balthazar, Regina L Tham, Badar Omar, Sangeeta Mauskar, Walter Wickremasinghe, Bartley G Jr Cilento, Caleb P Nelson","doi":"10.1016/j.urology.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.031","url":null,"abstract":"<p><strong>Objectives: </strong>To test the feasibility and efficacy of using an enuresis alarm to guide timing of post-void residual (PVR) measurement in two different cohorts of non-verbal, non-toilet trained pediatric patients.</p><p><strong>Methods: </strong>We prospectively enrolled 15 infants (Group 1) and 15 medically-complex patients (Group 2) to undergo an 8-hour study period that included a 4-hour intervention period with alarm (PVR after alarm trigger) and a 4-hour control period of routine care (PVR when nurses observe wet diapers). The primary endpoint of PVR volume was analyzed using linear regression with volume as the dependent variable and both study period and patient weight as independent variables. Secondary endpoint of the number of detected voids was analyzed using Mann-Whitney U test.</p><p><strong>Results: </strong>In Group 1, median number of voids detected was significantly greater in the alarm versus routine care periods (3 vs 2, p=0.0029). Use of alarm was associated with a non-significant mean decrease of 2.23 mL (95% CI -7.09 to 2.63, p=0.363) in PVR volume for infants. In Group 2, median number of detected voids were also significantly different in the alarm versus routine care periods (3 vs 1, p=0.0312). Use of alarm was associated with a mean decrease of 21.09 mL (95% CI -40.60 to -1.58, p=0.035) in PVR volume.</p><p><strong>Conclusions: </strong>An enuresis alarm facilitated detecting significantly more voids in both infants and medically-complex, non-verbal children and was also associated with a decrease in PVR volume in the latter group. Such use of enuresis alarms may prove useful to measure PVR more accurately in these challenging populations.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Contrast-enhanced ultrasound imaging following transperineal laser ablation for lower urinary tract symptoms\".","authors":"Ge Ge, Jian Liao, Xuanlin Chen, Chenli Liu","doi":"10.1016/j.urology.2025.01.027","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.027","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Urinary Sphincter Placement Before or After Radiation Therapy: Does Timing of Radiation Impact Surgical Complications and Continence?","authors":"Emily Bochner, Blake Johnson, Bryce Franzen, Alexandria Hertz, Ethan Matz, Steve Hudak, Maia VanDyke","doi":"10.1016/j.urology.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.003","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of radiation timing on artificial urinary sphincter (AUS) outcomes. AUS is the gold standard treatment for post-prostatectomy incontinence. Radiation history has been associated with worse outcomes, including higher rates of erosion and infection. The impact of radiation timing-before versus after AUS placement-has been less well studied.</p><p><strong>Methods: </strong>Patients undergoing AUS placement over a five-year period were retrospectively reviewed. Salvage prostatectomy patients were excluded. Patients were stratified by radiation timing: radiation prior to AUS placement (pre-AUS) versus after AUS placement (post-AUS). Outcomes included continence rate, improvement in pads per day, complications, and need for further surgery.</p><p><strong>Results: </strong>Of 315 post-prostatectomy AUS patients, 181 underwent radiation treatment. Excluding 42 patients for salvage prostatectomy, 123 patients underwent radiation pre-AUS and 16 post-AUS. Patients were slightly younger in the post-AUS group (p=.020); demographics were otherwise similar. Mean cuff size was similar in both groups. Continence rates were not significantly different (p=.509), nor was difference in pad per day improvement (-3.0 ppd for pre-AUS and -3.8 ppd in the post-AUS group (p=.379)). Over a median follow up of 27.7 months, 1/16 (6.6%) patients experienced device erosion in the post-AUS group, compared to 15/123 (12.2%) pre-AUS (median follow up 15.6 months). No patients in the post-AUS group experienced device infection, compared to 6/123 patients in the pre-AUS group. Revision rates were similar between the two groups (18.8% vs 25.2%, p= 0.761).</p><p><strong>Conclusions: </strong>Patients undergoing AUS placement prior to radiation experienced similar continence improvements and similar complications rates to those who underwent radiation following AUS.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Recep Burak Degirmentepe et al. Regarding \"Letter to the editor: Do We Need a Urine Culture Before Cystoscopy? Time to Shift Away From Routine Testing\".","authors":"Daniel Suso-Palau, Julián Chavarriaga","doi":"10.1016/j.urology.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.024","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking counseling on fertility preservation prior to vasectomy.","authors":"Darshan P Patel","doi":"10.1016/j.urology.2025.01.033","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.033","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Outcomes & Anatomical Changes in the Upper Urinary Tract following Flexible Ureteroscopy with a Flexible and Navigable Suction Ureteral Access Sheath (FANS): 3-Month Results from a Multicenter Study.","authors":"Khi Yung Fong, Steffi Kar Kei Yuen, Bhaskar Kumar Somani, Vigen Malkhasyan, Yiloren Tanidir, Satyendra Persaud, Albert El Hajj, Chu-Ann Chai, Tzevat Tefik, Karl Tan, Mohamed Elshazly, Deepak Ragoori, Mehmet Ilker Gokce, Boyke Soebhali, Saeed Bin Hamri, Nariman Gadzhiev, Ben Turney, Olivier Traxer, Daniele Castellani, Vineet Gauhar","doi":"10.1016/j.urology.2025.01.029","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.029","url":null,"abstract":"<p><strong>Objectives: </strong>To study the long-term outcomes of the flexible and navigable suction ureteral access sheath (FANS) in flexible ureteroscopy (FURS). FANS has well-established efficiency and 30-day perioperative safety; however, its influence on pelvicalyceal and ureteric anatomy remains to be investigated.</p><p><strong>Methods: </strong>This was a prospective study of patients with normal renal anatomy who underwent FURS with FANS for renal stones from April 2023 to August 2024 in 16 centers worldwide. 30-day postoperative stone free rate and delayed complications after 3 months were analyzed with a non-contrast CT scan and contrasted CT urogram respectively. The primary aim was to report if FANS could potentially cause pelviureteric junction, pelvicalyceal or ureteric complications.</p><p><strong>Results: </strong>310 patients were analyzed. Median age was 51; median stone volume was 1584 mm³. Disposable scopes were used in 58.1%. Predominant laser energies were Thulium fiber laser (56.1%) followed by Thulium-YAG laser (20.6%). Median laser time was 14min, median ureteroscopy time was 30min, and median total operation time was 45min. Ureteric injury occurred in 11 patients (3.5%), of which 10 were Traxer-Thomas Grade 1. On 30-day NCCT, 63.5% of patients had zero residual fragments; overall stone-free status was seen in 95.1%. 30-day reintervention rate was 4.2% (13 cases). 3-month CT urogram showed ureteric stenosis in only 1 patient (0.3%) who was managed by dilatation and stenting. No other anatomical anomalies were recorded.</p><p><strong>Conclusions: </strong>The extremely low rates of 3-month adverse outcomes, high immediate SFR, and low 30-day reintervention rates further strengthen the evidence for safety and effectiveness of FANS.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Surgical outcomes of the ZSI475 FtM inflatable erectile prosthesis implantation after phalloplasty.\"","authors":"Mang L Chen","doi":"10.1016/j.urology.2025.01.021","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.021","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low baseline IsoPSA Index is associated with a Prolonged Low Risk of Clinically Significant Prostate Cancer Diagnosis in Men with an Elevated PSA.","authors":"Nour Abdallah, Rebecca A Campbell, Tarik Benidir, Andrew Wood, Zaeem Lone, Ao Zhang, Onuralp Ergun, Caleb Curry, Patrick Michael, Ross Liao, Jaya Sai Chavali, Alberto Pieretti, Jesse McKenney, Andrei Purysko, Samuel Haywood, Zeyad Schwen, Ruben Olivares, Jihad Kaouk, Robert Abouassaly, Eric A Klein, Christopher J Weight","doi":"10.1016/j.urology.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.019","url":null,"abstract":"<p><strong>Objective: </strong>To compare the rate of diagnosing clinically significant prostate cancer (csPCa) in men with elevated PSA stratified by baseline IsoPSA Index, thus assessing IsoPSA's intermediate-term predictive ability for csPCa.</p><p><strong>Material and methods: </strong>Single-center retrospective review of consecutive patients (n=1578) who underwent IsoPSA testing from November 2016-August 2022. Data dichotomized into patients with low(≤6) and high IsoPSA Indices (>6). Most recent subsequent IsoPSA and PSA tests, prostate biopsy, and MRI collected. Time-to-event Kaplan-Meier estimates generated for the risk of csPCa stratified by baseline IsoPSA Index.</p><p><strong>Results: </strong>Among 541 patients with initial low IsoPSA Indices (≤6), 23 (4.3%) were diagnosed with csPCa on a subsequent biopsy. Also, among these 541 patients, 204 had an MRI, of which 48/204 (23.5%) showed suspicious lesions(PIRADS≥4). Among 1037 patients with initial high IsoPSA Indices, 366 (35.3%) were diagnosed with csPCa on a subsequent biopsy. Also, among these 1037 patients, 712 had an MRI, of which 342/712 (48.0%) showed suspicious lesions (PIRADS≥4). After 12, 24, and 30 months, respectively, the risk of developing csPCa was 0.4% (95% CI 0.1%-1.6%), 2.5% (1.4%-4.4%), and 6.3% (4%-9.6%) in patients with low IsoPSA Indices, compared to 5.9% (4.6%-7.6%), 31.7% (28.3%-35.4%), and 49.5% (45.3%-53.9%) in patients with high IsoPSA Indices. Limitations include the retrospective review of prospectively collected data and unknown true csPCa rates as not all patients were biopsied.</p><p><strong>Conclusions: </strong>The risk of developing csPCa was smaller in patients with initial low vs high IsoPSA Indices over the ensuing 30 months, which supports using IsoPSA to safely avoid follow-up testing.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical Education in Reproductive Urology: A Review of Current Techniques and Opportunities for Improved Access to Learning Experiences.","authors":"Kimberly Waggener, Dylan Wolff, Madeline Snipes, Stephen Tranchina, XiXi Yi, Daniel Boaretto, Akhil Muthigi, Nicholas A Deebel","doi":"10.1016/j.urology.2025.01.025","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.025","url":null,"abstract":"<p><p>Infertility is a common problem. Despite this, a dearth of urologists are trained in infertility care. Improved training opportunities may improve proficiency and interest in subspecialized training. We present a narrative review of current and proposed techniques in microsurgical education, with noted methods from other specialties. Opportunities for quality improvement include technological advancements, dedicated training laboratories, and artificial and animal models. Ample opportunity exists for improvement and standardization of microsurgical skills training, institutionally and nationally. Adoption of training methods may bolster resident interest in andrology and male infertility as a career and improve outcomes for those who complete fellowship training.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign Prostatic Hyperplasia Knowledge Deficits Among Male Urology Patients.","authors":"Suruchi Ramanujan, Peace Orji, Austin Chiu, Sailakshmi Senthil Kumar, William Jevnikar, Bailey Cox, Drogo Montague, Nima Almassi, Byron Lee, James Bena, Shannon Morrison, Ali Cyrus Chehroudi, Petar Bajic, Smita De","doi":"10.1016/j.urology.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.023","url":null,"abstract":"<p><strong>Objective: </strong>To measure patient knowledge about Benign prostatic hyperplasia (BPH) and identify factors associated with knowledge deficiencies among those newly presenting to our urology clinic.</p><p><strong>Methods: </strong>Adult men presenting as new patients to our institution's urology clinic regardless of chief complaint were invited to complete a 26-item multiple choice questionnaire to assess basic knowledge about BPH, related symptomatology, and treatment options prior to their initial consultation. Responses were correlated to demographic variables using ANOVA and multivariable linear modeling.</p><p><strong>Results: </strong>206 patients completed the questionnaire and had a mean age of 60.8 years. The majority were White (85.6%) and 28.9% were Medicare/Medicaid insured. The mean correct response rate was 62% (standard deviation of 22.9%) with the worst performing domain being BPH complications. Having a graduate or professional degree (p<0.001) and self-referral were associated with significantly higher scores (p=0.027).</p><p><strong>Conclusions: </strong>There remain significant knowledge gaps about BPH among men seeking urologic care. Education tools for both patients and primary care physicians may help improve health literacy as well as health outcomes for patients with BPH.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}