IF 2.1 3区医学

Urology Pub Date : 2025-01-14 DOI: 10.1016/j.urology.2025.01.026

Steffi Kar Kei Yuen, Vineet Gauhar

引用次数: 0

Robotic Waterjet Resection for Men with Prostate Cancer Suffering from Lower Urinary Tract Symptoms. 机器人水射流切除患有下尿路症状的前列腺癌患者。

IF 2.1 3区医学

Urology Pub Date : 2025-01-14 DOI: 10.1016/j.urology.2025.01.020

Jeremy Yuen Chun Teoh, Steffi Kar Kei Yuen, Becky Sui Yan Lau, Franco Pui Tak Lai, Ka Lok Lee, Peter Ka Fung Chiu, Chi Hang Yee, Chi Fai Ng

{"title":"Robotic Waterjet Resection for Men with Prostate Cancer Suffering from Lower Urinary Tract Symptoms.","authors":"Jeremy Yuen Chun Teoh, Steffi Kar Kei Yuen, Becky Sui Yan Lau, Franco Pui Tak Lai, Ka Lok Lee, Peter Ka Fung Chiu, Chi Hang Yee, Chi Fai Ng","doi":"10.1016/j.urology.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.020","url":null,"abstract":"Objectives: To evaluate the impact of Aquablation on circulating tumor cells (CTCs) in men with localized prostate cancer.Methods: This prospective study included subjects with biopsy-positive mpMRI visible lesions (PIRADS ≥ 3) who underwent Aquablation. Ten ml blood samples were collected before, during and after the procedure to measure CTC counts using an immunofluorescence assay.Results: The mean age of participants was 63.4 years, with a baseline PSA of 8.9 ng/ml and a prostate volume of 60.3 ml. All subjects experienced reduced IPSS scores and stable or improved SHIM and MSHQ-EjD scores. Detectable CTCs were found in 80% of subjects before Aquablation, 100% immediately after, 20% on post-op day 2, and 60% on post-op day 7. The mean number of CTCs per patient 10 ml blood draw was 1.2 pre-operatively, 3.2 immediately post-op, 0.2 on day 2, and 1.0 on day 7. Prostate volumes decreased significantly at 3 and 6 months, with corresponding reductions in PSA levels. There were no adverse events reported. Specifically, no instances of incontinence, erectile dysfunction, ejaculatory dysfunction or rectal toxicity were observed. At 6 month follow-up, all baseline mpMRI lesions were no longer visible on mpMRI and follow-up biopsies showed no grade group progression.Conclusions: In an active surveillance population, Aquablation resulted in improved urinary function, stable or improved sexual function and a transient spike in CTCs lasting <2 days that did not result in any oncologic concern. Aquablation may be considered a safe option for men with localized prostate cancer who require treatment for LUTS due to BPH.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012390","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

Testicular atrophy following torsion in pediatric patients. Results of a long-term follow-up. 小儿扭转后睾丸萎缩。长期随访的结果。

IF 2.1 3区医学

Urology Pub Date : 2025-01-13 DOI: 10.1016/j.urology.2025.01.017

Sasa Milivojevic, Djordje Topalovic, Ivana Dasic, Sofija Cvejic, Ivana Filipovic, Sladjana Mihajlovic, Marko Jovic, Jelena Milin Lazovic

{"title":"Testicular atrophy following torsion in pediatric patients. Results of a long-term follow-up.","authors":"Sasa Milivojevic, Djordje Topalovic, Ivana Dasic, Sofija Cvejic, Ivana Filipovic, Sladjana Mihajlovic, Marko Jovic, Jelena Milin Lazovic","doi":"10.1016/j.urology.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.017","url":null,"abstract":"Objectives: To assess torsion outcomes and evaluates the rate of testicular atrophy.Methods: The study was done over the 2000-2024 period during which 103 patients of average age 12.9± 3.0 were echosonographically followed up after operative detorquation and testicular salvage. The study included three groups based on the timing of intervention: Group 1 \"<6h\", Group 2 \"6-12h\" and Group 3 \">12h\". The median follow up for all groups was 65 (60-84) months.Results: The presence of a detorsed testis was significantly higher in the Group 1 where all cases had existing testis, compared to 64.7% in the Group 2 and only 20.8% in the Group 3 (p<0.001). The detorsed testis volume was significantly larger in the Group 1 compared to the Group 2 and the Group 3 (p<0.001 for both comparisons). The analysis of blood flow through the testis revealed significant differences between the groups (p<0.001). The structure homogenousness was present in 20 (55.6%) patients in the Group 1, and non-existent in all the patients in the Group 2 and the Group 3, (p<0.001).Conclusions: The risk of testicular atrophy after many years of follow-up is significantly higher compared to the current literature. Testicular salvage is not possible if more than 6 hours have passed since the onset of symptoms. The high incidence of heterogeneous presentation on ultrasound of salvaged testes, which did not show signs of atrophy, raises the question of the possible harmful impact of salvaged testes on male fertility.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012391","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

Deep Learning for Predicting Difficulty in Radical Prostatectomy: A Novel Evaluation Scheme. 深度学习预测根治性前列腺切除术难度：一种新的评估方案。

IF 2.1 3区医学

Urology Pub Date : 2025-01-13 DOI: 10.1016/j.urology.2025.01.028

Haonan Mei, Zhongyu Wang, Qingyuan Zheng, Panpan Jiao, Jiejun Wu, Xiuheng Liu, Rui Yang

{"title":"Deep Learning for Predicting Difficulty in Radical Prostatectomy: A Novel Evaluation Scheme.","authors":"Haonan Mei, Zhongyu Wang, Qingyuan Zheng, Panpan Jiao, Jiejun Wu, Xiuheng Liu, Rui Yang","doi":"10.1016/j.urology.2025.01.028","DOIUrl":"https://doi.org/10.1016/j.urology.2025.01.028","url":null,"abstract":"Objectives: To explore new metrics for assessing radical prostatectomy difficulty through a two-stage deep learning method from preoperative magnetic resonance imaging.Methods: The procedure and metrics were validated through 290 patients consisting of laparoscopic and robot-assisted radical prostatectomy procedures from two real cohorts. The nnUNet_v2 adaptive model was trained to perform accurate segmentation of the prostate and pelvis. A modified network PointNet was used for indirectly regressing 15 anatomical landmarks based on Gaussian heatmaps. Novel metrics proposed in this study that characterized the spatial relationship between the prostate and pelvis were included to evaluate the surgical difficulty.Results: The two-stage process achieved decent segmentation and landmark localization results with the Mean Validation Dice of 0.8641 and millimeter-level accuracy. We found the coefficients of PV, ρ, PT, PAP, AG, PSD1, PSD2, πρ2/ISTA, AG+PG, AG×PG, PSD2×ρ, PAP/(AG+PG) with Estimated Blood Loss and PSD2, PSD2×ρ with Operation Time, respectively with statistic significant, which provides possibilities for assessing surgical difficulty evaluation. The entire pipeline had been validated on the external dataset, and the results were consistent.Conclusions: The two-stage anatomical landmark localization approach is feasible. Indicators describing pelvic-prostate spatial constraints significantly impact surgical difficulty in radical prostatectomy, leading to increased blood loss and longer operation times, while isolated pelvic measurements have minimal effect on surgical outcomes.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012666","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

The change of detrusor contractility at 5 years after transurethral resection of the prostate: a single center prospective observational study. 经尿道前列腺切除术后5年逼尿肌收缩力的变化：单中心前瞻性观察研究。

IF 2.1 3区医学

Urology Pub Date : 2025-01-13 DOI: 10.1016/j.urology.2024.12.038

Yuki Kyoda, Kosuke Shibamori, Kimihito Tachikawa, Seisuke Nofuji, Yoko Saito, Hidetoshi Tabata, Tetsuya Shindo, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori

{"title":"The change of detrusor contractility at 5 years after transurethral resection of the prostate: a single center prospective observational study.","authors":"Yuki Kyoda, Kosuke Shibamori, Kimihito Tachikawa, Seisuke Nofuji, Yoko Saito, Hidetoshi Tabata, Tetsuya Shindo, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori","doi":"10.1016/j.urology.2024.12.038","DOIUrl":"https://doi.org/10.1016/j.urology.2024.12.038","url":null,"abstract":"Objective: To prospectively assess the impact of transurethral resection of the prostate (TURP) on detrusor function using pressure flow study (PFS) at 5 years after surgery in a single center prospective non-randomized observational study.Methods: Sixty consecutive male patients were prospectively enrolled and underwent TURP from November 2014 to November 2018. A questionnaire survey, free uroflowmetry and PFS were performed at baseline, and 6, 24 and 60 months after surgery. We divided the age groups at 70 years and defined the younger group as those younger than 70 years old, and the elderly group as those aged 70 years or older. The primary endpoint was the change of the bladder contractility index (BCI).Results: Of the 60 patients, 39 completed the protocol. Regardless of age, the bladder outlet obstruction indices at 6, 24, and 60 months after surgery were significantly lower than before surgery (all, p<0.01). Although the BCI did not significantly change during 60 months for the entire group of 39 patients, it was significantly decreased at 60 months (85.6) after surgery compared to before surgery (102) in the elderly group (p=0.02).Conclusion: We prospectively evaluated detrusor contractility up to 5 years after TURP. It was significantly reduced in the elderly, in spite of which the relief of bladder outlet obstruction was maintained for 5 years after surgery.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012392","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 for "Socioeconomic Disparities in Upper Tract Urothelial Carcinoma (UTUC) Management: A Regional Cohort Study". 上尿路上皮癌（UTUC）管理的社会经济差异：一项区域队列研究

IF 2.1 3区医学

Urology Pub Date : 2025-01-13 DOI: 10.1016/j.urology.2025.01.018

Ava Saidian

引用次数: 0

Editorial Comment on Racial and Ethnic Representation in Nephrolithiasis Guidelines: Are They Generalizable? 关于肾结石指南中种族和民族代表性的评论：它们是可推广的吗？

IF 2.1 3区医学

Urology Pub Date : 2025-01-11 DOI: 10.1016/j.urology.2025.01.022

Charles D Scales

引用次数: 0

Editorial Comment on "Trends in Urology Residency Applications: Results from The Society of Academic Urologists Program Director Survey from 2022 to 2024". 关于“泌尿科住院医师申请趋势：来自学术泌尿科医师协会项目主任调查的结果，从2022年到2024年”的社论评论。

IF 2.1 3区医学

Urology Pub Date : 2025-01-11 DOI: 10.1016/j.urology.2025.01.016

Lauren E Chew, Jeffrey L Ellis

引用次数: 0

Routine Sperm Cryopreservation before Vasectomy Is Not Cost-Effective and Does Not Increase Live Birth Rates Compared to Surgical Sperm Retrieval or Vasectomy Reversal. 输精管切除术前常规精子冷冻保存与手术精子提取或输精管切除术逆转相比，不具有成本效益，也不会增加活产率。

IF 2.1 3区医学

Urology Pub Date : 2025-01-10 DOI: 10.1016/j.urology.2024.12.050

Bradley J Roth, Andrew D Shumaker, Petar Bajic, Sarah C Vij, Pietro E Bortoletto, Scott D Lundy

{"title":"Routine Sperm Cryopreservation before Vasectomy Is Not Cost-Effective and Does Not Increase Live Birth Rates Compared to Surgical Sperm Retrieval or Vasectomy Reversal.","authors":"Bradley J Roth, Andrew D Shumaker, Petar Bajic, Sarah C Vij, Pietro E Bortoletto, Scott D Lundy","doi":"10.1016/j.urology.2024.12.050","DOIUrl":"https://doi.org/10.1016/j.urology.2024.12.050","url":null,"abstract":"Objectives: To determine if routine pre-vasectomy sperm cryopreservation is more cost-effective than fertility restoration for patients who desire additional children following vasectomy?Methods: A scoping review was performed to collect published data regarding efficacy and outcomes of cryopreservation, vasectomy reversal, surgical sperm retrieval, and assisted reproductive technologies (ART). Cost data were collected from US-based facilities performing cryopreservation and andrology clinical care. A cost-effectiveness model was generated using TreeAge Pro cost-effectiveness modeling software with three different variations representing a balanced scenario with median expected parameter values, a scenario with assumptions/variables favoring pre-vasectomy cryopreservation, and a scenario favoring fertility restoration. The primary outcome was cost per live birth and the secondary outcome was overall live birth rate.Results: Pre-vasectomy cryopreservation cost ($140,247, range $48,232 - $552,807 per live birth) was significantly higher than with fertility restoration ($20,059, range $20,059 - $30,698). Surprisingly, pregnancy success rates appeared to be incrementally higher in the fertility restoration group (62%, range 44% - 66%) compared to cryopreservation (46%, range 36% - 58%) when using published literature values.Conclusions: Routine sperm cryopreservation prior to vasectomy conveys a significantly higher cost to patients and the healthcare system and does not appear to increase live birth rate compared to fertility restoration with sperm retrieval or vasectomy reversal. Patients without fertility risk factors should be counseled on the added cost and need for ART with pre-vasectomy cryopreservation but should still be allowed to proceed if desired.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972309","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

RETHINKING LOW TESTOSTERONE IN OLDER MEN: ASSOCIATION WITH OBESITY RATHER THAN AGING. 重新思考老年男性睾酮水平低：与肥胖而非衰老有关。

IF 2.1 3区医学

Urology Pub Date : 2025-01-10 DOI: 10.1016/j.urology.2024.12.036

Taciana Leonel Nunes Tiraboschi, Eduardo P Miranda, Monique Tonani Novaes, Caroline Santos Silva, Jean Carlos Zambrano Contreras, Jarbas de Sá Roriz Filho, Ernesto Reggio, Caio Vinícius Suartz, Cristiano Mendes Gomes, José de Bessa

{"title":"RETHINKING LOW TESTOSTERONE IN OLDER MEN: ASSOCIATION WITH OBESITY RATHER THAN AGING.","authors":"Taciana Leonel Nunes Tiraboschi, Eduardo P Miranda, Monique Tonani Novaes, Caroline Santos Silva, Jean Carlos Zambrano Contreras, Jarbas de Sá Roriz Filho, Ernesto Reggio, Caio Vinícius Suartz, Cristiano Mendes Gomes, José de Bessa","doi":"10.1016/j.urology.2024.12.036","DOIUrl":"https://doi.org/10.1016/j.urology.2024.12.036","url":null,"abstract":"Background: The decline in testosterone levels among older men remains a subject of debate. While some cross-sectional and longitudinal studies have reported a decrease in testosterone with advancing age, others have not observed this trend. In this study, we aimed to evaluate testosterone levels and identify predictors of low testosterone in an age-stratified cohort of men.Methods: From January 2016 to June 2022, a cohort of men receiving routine care at a primary care center was prospective analyzed. Participants were stratified into age groups: 45-64 years (middle-aged), 65-74 years (young-old), 75-84 years (middle-old), and ≥85 years (oldest-old). Comprehensive clinical and laboratory assessments were conducted, including waist circumference, glucose levels, triglycerides, HDL cholesterol, and total testosterone. Low testosterone was defined as levels below 300 ng/dL. Metabolic syndrome was diagnosed in accordance with established diagnostic criteria.Results: The study included 3.489 subjects across age groups. Median testosterone levels were similar across all age groups. The prevalence of low testosterone was around 20% in all groups and did not significantly vary with age. Obesity, as indicated by increased waist circumference (WC) >102 cm, was strongly associated with low testosterone. The prevalence of low testosterone increased from 8% in those with WC≤93 cm to 44% in those with WC≥110 cm.Conclusions: This study highlights the significant association between low testosterone levels and obesity, reinforcing the importance of addressing comorbidities in testosterone decline.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972264","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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