IF 2 3区医学

Urology Pub Date : 2025-09-29 DOI: 10.1016/j.urology.2025.09.039

Ahmet Burak Yilmaz, Kamal Karimzada, Tanju Keten, Ozer Guzel, Altug Tuncel

引用次数: 0

Urology Autonomy Maps: Evaluation of Attending Surgeon Expectations for Resident Competencies in Common Urology Procedures. 泌尿外科自主地图：评估主治医生对普通泌尿外科手术住院医师能力的期望。

IF 2 3区医学

Urology Pub Date : 2025-09-28 DOI: 10.1016/j.urology.2025.09.044

David G Hanelin, Jonah Tripp, Alexander Sankin, Nitya Abraham

{"title":"Urology Autonomy Maps: Evaluation of Attending Surgeon Expectations for Resident Competencies in Common Urology Procedures.","authors":"David G Hanelin, Jonah Tripp, Alexander Sankin, Nitya Abraham","doi":"10.1016/j.urology.2025.09.044","DOIUrl":"https://doi.org/10.1016/j.urology.2025.09.044","url":null,"abstract":"Objectives: To improve resident education by assessing attending urologists' expectations for resident competency in common urological procedures and to create procedure-specific \"autonomy maps\" to visually present expected progression of surgical independence.Methods: This cross-sectional survey of urologists at a single institution evaluated ten common urologic procedures. Faculty were asked to identify procedural steps and assign a postgraduate year (PGY) at which a resident should be able to complete each surgical step with passive help. Linear regression and ANOVA tests were conducted to assess whether faculty demographics influenced assigned PGY competency levels for each procedure. Aggregated responses were used to create color-coded autonomy maps by PGY level.Results: 20 faculty members across six urologic subspecialties completed the survey. More complex surgical steps (e.g., lobe resection in TURP) were assigned higher PGY levels, while competency in foundational tasks (e.g., cystoscopy) was expected earlier. No faculty assigned identical expectations, highlighting variability in expectations. Faculty demographics were not significantly associated with autonomy expectations.Conclusions: The created autonomy maps provide a standardized, visual framework to clarify faculty expectations and guide resident development. These maps are intended to supplement rather than displace validated tools such as the Zwisch scale, OSATS, and OpTrust. Used together, these tools may enhance transparency, structure, and educational outcomes in surgical training.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201290","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}

引用次数: 0

Editorial Comment on "Postoperative Symptom Severity and Time Course After Bilateral Ureteroscopy With Stents: Results From the Study to Enhance Understanding of Stent-associated Symptoms (STENTS)". 对“双侧输尿管镜下支架术后症状严重程度和时间进程：加强对支架相关症状（Stents）理解的研究结果”的评论。

IF 2 3区医学

Urology Pub Date : 2025-09-28 DOI: 10.1016/j.urology.2025.09.042

Kunal Jain, Kevin Koo

引用次数: 0

Editorial Comment on "Assessing the diagnostic performance of renal ultrasound in microhematuria evaluation: validation of the AUA Microhematuria 2020 guidelines". 《肾超声在微量血尿评估中的诊断性能评估：AUA微量血尿2020指南的验证》社论评论。

IF 2 3区医学

Urology Pub Date : 2025-09-26 DOI: 10.1016/j.urology.2025.09.036

Meera R Chappidi, Sima P Porten

引用次数: 0

Impact of GLP-1 Receptor Agonists on Male Fertility: Emerging Evidence and Future Directions. GLP-1受体激动剂对男性生育能力的影响：新证据和未来方向。

IF 2 3区医学

Urology Pub Date : 2025-09-26 DOI: 10.1016/j.urology.2025.09.038

Manish Kuchakulla, Phillip J Poppas, Gal Wald, John M Masterson, Aaron A Gurayah, Hriday P Bhambhvani, James A Kashanian

{"title":"Impact of GLP-1 Receptor Agonists on Male Fertility: Emerging Evidence and Future Directions.","authors":"Manish Kuchakulla, Phillip J Poppas, Gal Wald, John M Masterson, Aaron A Gurayah, Hriday P Bhambhvani, James A Kashanian","doi":"10.1016/j.urology.2025.09.038","DOIUrl":"https://doi.org/10.1016/j.urology.2025.09.038","url":null,"abstract":"Objective: To synthesize emerging mechanistic, preclinical, and clinical evidence evaluating the impact of GLP-1RAs on male fertility, including effects on testicular function, reproductive hormones, semen parameters, and sexual function.Methods: A comprehensive literature search was conducted across PubMed, MEDLINE, and Embase through May 31, 2025, identifying relevant preclinical and clinical studies examining GLP-1RAs and male reproductive health.Results: The search strategy identified 16 clinical studies meeting our inclusion criteria, and these studies were included in the summary tables for review. GLP-1 receptors are present in male reproductive tissues. Preclinical studies indicate GLP-1RAs enhance spermatogenesis, hormone profiles, and sperm function in obese/diabetic rodent models via cAMP/PKA and PI3K/Akt pathways. In vitro data show improved sperm motility and Sertoli cell metabolism with GLP-1RAs. Limited clinical studies suggest potential improvements in semen parameters and testosterone levels in obese hypogonadal men, though heterogenous results highlight the need for further research.Conclusions: GLP-1RAs likely have a beneficial effect on male fertility, particularly in the setting of metabolic dysfunction, but clinical evidence is limited. Larger prospective studies are needed to confirm safety and efficacy.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186756","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}

引用次数: 0

Editorial Comment on "Economic Burden of Urinary Incontinence in Men with Prostate Cancer: Results from the Medical Expenditure Panel Survey (2016-2021)". 《前列腺癌男性尿失禁的经济负担：来自医疗支出小组调查（2016-2021）的结果》

IF 2 3区医学

Urology Pub Date : 2025-09-26 DOI: 10.1016/j.urology.2025.09.033

Elham Vafaei

引用次数: 0

Commentary on "Uncovering the Rare: A Systematic Review and Patient-Level Meta-analysis of Testicular Metastases from Renal Cell Carcinoma". “发现罕见：肾细胞癌睾丸转移的系统回顾和患者水平荟萃分析”评论。

IF 2 3区医学

Urology Pub Date : 2025-09-26 DOI: 10.1016/j.urology.2025.09.031

Francesco Di Bello, Andrea Gallioli, Angelo Territo, Alberto Breda

引用次数: 0

Quality of Life and Postoperative Complications of Single- or Bilateral-Stoma Cutaneous Ureterostomy Compared to Ileal Conduit After Radical Cystectomy: A Systematic Review and Meta-Analysis. 与根治性膀胱切除术后的回肠导管相比，单口或双口皮肤输尿管造口术的生活质量和术后并发症：一项系统回顾和荟萃分析。

IF 2 3区医学

Urology Pub Date : 2025-09-25 DOI: 10.1016/j.urology.2025.09.034

Marvel Pratama Tjiaman, Muhammad Zen Zaidan, Zidan Fawwaz Ausath, Aurellie Tabitha Putri, Anneta Sanjaya Tjiaman, Armand Achmadsyah, Ervita Mediana, Agus Rizal Ardy Hariandy Hamid

{"title":"Quality of Life and Postoperative Complications of Single- or Bilateral-Stoma Cutaneous Ureterostomy Compared to Ileal Conduit After Radical Cystectomy: A Systematic Review and Meta-Analysis.","authors":"Marvel Pratama Tjiaman, Muhammad Zen Zaidan, Zidan Fawwaz Ausath, Aurellie Tabitha Putri, Anneta Sanjaya Tjiaman, Armand Achmadsyah, Ervita Mediana, Agus Rizal Ardy Hariandy Hamid","doi":"10.1016/j.urology.2025.09.034","DOIUrl":"https://doi.org/10.1016/j.urology.2025.09.034","url":null,"abstract":"Objective: To compare postoperative complications and quality of life among patients undergoing ileal conduit (IC), single-stoma cutaneous ureterostomy (SSCU), and bilateral-stoma cutaneous ureterostomy (BSCU) following radical cystectomy for muscle-invasive bladder cancer (MIBC). Method This systematic review and meta-analysis followed the Cochrane Handbook for Systematic Reviews of Interventions 6.2 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A comprehensive literature search was performed on PubMed, Cochrane, Wiley, and Scopus starting from 11 April 2025.Result: Eleven studies met the inclusion criteria. IC showed significantly better physical QoL based on FACT scores (SMD: 0.63; 95% CI: 0.02-1.24; p = 0.04), particularly compared to BSCU (MD: 18.43; p < 0.0001), with no significant difference versus SSCU. However, IC had a higher risk of wound infection (OR: 3.02; p = 0.004) and early pyelonephritis (OR: 3.04; p = 0.02), especially when compared to SSCU. No significant differences were observed in ileus or wound dehiscence.Conclusion: IC may offer better physical QoL, particularly over BSCU. However, SSCU offers similar QoL with lower rates of infection and pyelonephritis.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182191","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}

引用次数: 0

Uncertainty During Ureteroscopy: Evaluating Surgeon Consensus on In Vivo Stone Dust After Laser Lithotripsy. 输尿管镜检查的不确定性：评估外科医生对激光碎石后体内石尘的共识。

IF 2 3区医学

Urology Pub Date : 2025-09-25 DOI: 10.1016/j.urology.2025.09.028

Levi Bowers, Kimberly Maciolek, Ryan S Hsi, Nicholas Kavoussi

{"title":"Uncertainty During Ureteroscopy: Evaluating Surgeon Consensus on In Vivo Stone Dust After Laser Lithotripsy.","authors":"Levi Bowers, Kimberly Maciolek, Ryan S Hsi, Nicholas Kavoussi","doi":"10.1016/j.urology.2025.09.028","DOIUrl":"https://doi.org/10.1016/j.urology.2025.09.028","url":null,"abstract":"Objective: To evaluate surgeon consensus on stone dust quality and the ability to predict stone-free status based on intraoperative endoscopic appearance during ureteroscopy with laser lithotripsy.Methods: Fifteen urologists (7 faculty, 8 trainees) reviewed 16 videos of ureteroscopic laser lithotripsy, blinded to clinical outcomes. Eight videos were from patients who were stone-free at 6-week postoperative CT; eight had residual fragments. Reviewers rated stone dust quality on a 5-point Likert scale and predicted stone-free status. Inter-rater reliability was measured using the intraclass correlation coefficient (ICC). Accuracy of stone-free prediction was compared using a two-tailed t-test.Results: Inter-rater agreement on dust quality was poor (ICC = 0.41), with slightly higher agreement among faculty (ICC = 0.49) compared to trainees (ICC = 0.38). Mean accuracy of stone-free prediction was 63% (SD: 9%), with no significant difference between faculty and trainees (67% vs 58%, p = 0.05). Sensitivity and specificity of predicting residual fragments were 55% and 72%, respectively. Confidence in predictions did not differ between groups. Notably, three of eight cases with residual fragments resulted in significant clinical events (ICU admission, reintervention), with mean time to event of 221 days. In these, surgeon prediction accuracy remained modest (63%, SD: 14%).Conclusion: Surgeon assessment of stone dust quality is inconsistent, and predictive accuracy for stone-free status based on endoscopic appearance is limited. These findings underscore the need for standardized definitions and objective intraoperative tools to optimize outcomes in laser stone surgery.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182230","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}

引用次数: 0

Management Trends of Urethral Stricture Disease: A Two-Decade (2000-2024) Comparison between Veteran and Civilian Populations. 尿道狭窄疾病的管理趋势：二十年（2000-2024）退伍军人与平民的比较

IF 2 3区医学

Urology Pub Date : 2025-09-25 DOI: 10.1016/j.urology.2025.09.030

Merlin Mamachan, Kylie Morgan, Austin Thompson, Michael Witthaus, Jagadeesh Thippeswamy, Sirpi Nakeeeran, Nannan Thirumavalavan, Kyoko Sakamoto, Mahadevan Rajasekaran

{"title":"Management Trends of Urethral Stricture Disease: A Two-Decade (2000-2024) Comparison between Veteran and Civilian Populations.","authors":"Merlin Mamachan, Kylie Morgan, Austin Thompson, Michael Witthaus, Jagadeesh Thippeswamy, Sirpi Nakeeeran, Nannan Thirumavalavan, Kyoko Sakamoto, Mahadevan Rajasekaran","doi":"10.1016/j.urology.2025.09.030","DOIUrl":"https://doi.org/10.1016/j.urology.2025.09.030","url":null,"abstract":"Objective: To evaluate trends in the prevalence of urethral stricture disease (USD) and treatment approaches within the veteran and civilian populations over the past two decades, with an emphasis on the impact of the American Urological Association (AUA) 2016 recommendations.Methods: We accessed the medical records of 476,715 randomly selected male veterans from 2000 to 2024 using the VA Informatics and Computing Infrastructure (VINCI). Patients were identified through ICD-9 and ICD-10 codes, with urethroplasty as the primary endpoint (CPT code 53400). Additional treatments were also analyzed, including Direct Vision Internal Urethrotomy (DVIU) (CPT 52276) and Urethral Dilation (UD) (CPT 53600). Similarly, a retrospective analysis of procedures performed in the general population was conducted using electronic health record data from the TriNetX Research Network. Treatment trends were stratified by diagnosis year, comparing 2000-2016 and 2017-2024.Results: A total of 63,810 veterans were diagnosed with USD: 47,007 (73.7%) from 2000-2016 and 16,803 (26.3%) from 2017-2024. Of these, 211 underwent urethroplasty, with a higher percentage in the earlier period (0.4%) compared to the later period (0.2%). Non-surgical treatments (DVIU & UD) remained consistent across age groups. Urethroplasty patients were younger (median age 62) than those treated non-surgically. In the general population (TriNetX data), DVIU and dilation rates declined, while urethroplasty rates remained consistent across both periods.Conclusion: Suboptimal incorporation of urethroplasty management for USD is observed in both veteran and civilian populations. Our results suggest no significant improvement in the rates of Urethroplasty after the release of the 2016 AUA urethral stricture guidelines.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182269","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}

引用次数: 0

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