Urology最新文献

{"title":"Risk of Hypertension after Renal Trauma: An Analysis of a Large Insurance Claims Database.","authors":"Jane T Kurtzman, Matthew Swallow, Joshua J Horns, Tarah Woodle, Benjamin McCormick, Jeremy Myers","doi":"10.1016/j.urology.2025.07.045","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.045","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk of new-onset hypertension (HTN) after renal trauma (rT) using a large insurance claims database.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of Merative MarketScan records from 2011- 2017. Patients with rT were compared to controls with isolated bladder or urethral trauma. Patients were excluded if they had both trauma types, pre-existing hypertension, < 1 year of pre-trauma enrollment data, or age < 18 years old. Kaplan-Meier curves and multivariate Cox proportional hazards models assessed HTN risk between groups.</p><p><strong>Results: </strong>7,882 patients (4,703 rT) were included. In total, 35% of rT patients developed de-novo HTN compared to 21% of controls (p < 0.001). Multivariate analysis demonstrated that patients who suffered rT were nearly twice as likely to develop de-novo HTN (HR 1.8, p<0.001). Patients with renal trauma managed with either angioembolization or nephrectomy were at greatest risk of HTN (HR 3.4 and 2.4, respectively, p values < 0.005). HTN risk was also associated with older age, female sex, higher Charlson Comorbidity Index, longer stay, diabetes, obesity, hyperlipidemia, and alcohol use.</p><p><strong>Conclusions: </strong>Patients who suffer rT are at increased risk of developing de-novo HTN. Patients who undergo nephrectomy or angioembolization appear to be at the greatest risk compared to controls. Following renal trauma, patients should be counseled on the risk of new HTN and receive close monitoring of their blood pressure over time.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718711","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":"GLOBAL COLLABORATION IN UROLOGICAL SURGERY RESEARCH BETWEEN HIGH- AND LOW-INCOME COUNTRIES: A BIBLIOMETRIC SCOPING REVIEW.","authors":"Maxwell X Otiato, Kevin Muy, Kymora B Scotland","doi":"10.1016/j.urology.2025.07.019","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.019","url":null,"abstract":"<p><strong>Objective: </strong>To assess collaborations in global urological surgery research and trends in authorship representation for studies conducted in low- and middle-income countries (LMICs) METHODS: A systematic bibliometric scoping review was conducted using PRISMA guidelines to outline global collaboration patterns in urological surgery research. Literature searches in PubMed® and Scopus® included articles published from inception to January 1, 2024. Articles were included if they described urological surgery research involving a high-income country (HIC) conducted exclusively in LMICs. Articles were excluded if unrelated to urological surgery or if a collaboration between HICs and LMICs was not outlined. Data analysis was conducted from February to April 2024.</p><p><strong>Results: </strong>A total of 1,777 peer-reviewed articles were identified and 108 studies met inclusion criteria. Most articles (89.8%) were published in 2009 or later. A significant majority of studies (81.5%) involved at least one author from the LMIC of focus and were considered collaborative. First and senior authors predominantly originated from HICs, particularly in studies based in low-income countries (88.2% and 94.1%). 52 articles (48.15%) were focused on educational initiatives, followed by training (23%) and humanitarian efforts (13%). Sub-Saharan Africa contributed the largest share of studies (19%), while Latin America and the Caribbean had the highest collaboration rates (20%). Endourology was the most frequently studied field across the research areas.</p><p><strong>Conclusion: </strong>This study highlights an upward trend in international urological surgery research with collaborative partnerships. These findings set a benchmark for promoting and sustaining equitable participation in global urological surgery research based in LMICs.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699610","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":"The 2025 Urology Match: Results From the Society of Academic Urologists Medical Student Survey.","authors":"Srinath-Reddi Pingle, Ezra J Margolin, Michael Creswell, Sarah Faris, Kirsten Greene, Christopher Keel, Lee Richstone, Mathew Sorensen, Simone Thavaseelan, Erica Traxel, Moben Mirza, Gina M Badalato","doi":"10.1016/j.urology.2025.07.025","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.025","url":null,"abstract":"<p><strong>Objectives: </strong>To better understand the perspectives of the 2025 urology residency applicant cohort by analyzing survey data on key aspects of the application process.</p><p><strong>Methods: </strong>A survey consisting of 38 questions designed by the SAU was distributed by AUA to all applicants who submitted rank lists in the 2025 urology match. Descriptive analyses were performed on the responses, and qualitative themes were extracted from free-text answers.</p><p><strong>Results: </strong>382 applicants completed at least one survey question. Respondents were representative of all geographic regions and academic backgrounds. The median number of applications submitted was 49, and 90% of applicants utilized all 30 preference signals. Preference signaling affected interviews offered, with applicants receiving an average of 12.5 interviews from signaled programs compared to only 1.6 from non-signaled programs. On qualitative analysis, there was also a preference for in-person interviews, with applicants citing better assessment of program culture and interpersonal dynamics. Lastly, early notification for unmatched applicants was generally viewed as a favorable change to the match process by respondents.</p><p><strong>Conclusion: </strong>The results highlight key applicant perspectives on recent changes to the urology match process. Preference signaling appears to be a well-received addition to the match, while in-person interviews may be the preferred format despite cost concerns. These findings offer valuable insights for future refinements to the urology match process.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699611","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":"Financial Compensation for Resident Call Coverage During Parental Leave: An Actuarial Analysis.","authors":"Sameer Farooq, Sydney Sudderth, Harsha Mirchandani, Akanksha Mehta","doi":"10.1016/j.urology.2025.07.030","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.030","url":null,"abstract":"<p><strong>Objective: </strong>To propose that applying actuarial methods to make recommendations for financial compensation of residents for additional call related to co-resident parental leave is one option for decreasing potential resentment of those burdened while also improving wellness of those on parental leave.</p><p><strong>Methods: </strong>Our analysis focused on a cohort of 16 urology residents at one institution that took call during the 2024-2025 academic year. Resident salaries was used to determine the average hourly pay rate for each residency year. With an estimated 70-hour work week, the average number of hours worked during a weeknight call (7 hours) and weekend call (29 hours) was calculated. This calculation was used to determine total resident compensation needed to cover a six-week parental leave for one resident per year.</p><p><strong>Results: </strong>Assuming a 70-hour work week, one weeknight call was calculated to be equivalent to $275 and $247 for a junior and chief resident respectively. Similarly, one weekend of call was calculated to be $1,710 and $1,364 for a junior and chief resident, respectively. The estimated total cost to pay 1 junior resident and 1 chief resident to cover co-resident call for 6 weeks of parental leave is $7,743 per year, comprised of $4,216 for junior resident call and $3,527 for chief resident call (2024 dollars).</p><p><strong>Conclusions: </strong>At our institution, $7,743 per year would reliably cover the costs of compensating residents for additional call burden during a co-resident's six-week parental leave. Availability of such funds could reduce the anxiety associated with parental leave during training.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699609","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":"Editorial Comment on \"Cystectomy and Ileal Conduit for Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review of Outcomes for Different Surgical Approaches\".","authors":"Kevin J Hebert","doi":"10.1016/j.urology.2025.07.028","DOIUrl":"10.1016/j.urology.2025.07.028","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675906","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":"Editorial Comment on \"Exploring the Association Between Varicocele and Testosteron Deficiency in Men Over 50 Years of Age\".","authors":"Ahmet Cihan, Monzer Al Mortaza","doi":"10.1016/j.urology.2025.07.026","DOIUrl":"10.1016/j.urology.2025.07.026","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668612","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 \"Revisiting the Role of Lymphovascular Invasion in Prostate Cancer: A Narrative Review\".","authors":"Matthias May, Ingmar Wolff, Maximilian Burger, Sabine Brookman-May","doi":"10.1016/j.urology.2025.07.027","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.027","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675907","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":"Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost.","authors":"Camilo Arenas-Gallo, Mollie Goldman, Jack C Millot, Jacob McCann, Anyull D Bohorquez-Caballero, Stephen Rhodes, Vishu Chandrasekhar, Michael Callegari, Leo Puhalla, Adam Calaway, Randy Vince, Adithya Balasubramanian, Jim Hu, Bashir Al Hussein Al Awamlh, Spyridon P Basourakos, Lee Ponsky, Jonathan E Shoag","doi":"10.1016/j.urology.2025.07.022","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.022","url":null,"abstract":"<p><strong>Objective: </strong>To describe national trends, predictors, insurance and patient costs associated with sedation use during prostate biopsies.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Merative Marketscan Database from 2016 to 2021. Men undergoing prostate biopsy were identified using CPT codes. Biopsy type, anesthesia claims, comorbidities, and MRI use were determined through CPT/ICD-10 codes. Multivariable logistic regression assessed predictors of sedation use. Out-of-pocket costs were calculated by summing insurance copays, deductibles, and coinsurance, adjusted to 2021 dollars.</p><p><strong>Results: </strong>The final cohort included 172,148 prostate biopsies. The mean patient age was 62 ± 8 years. The proportion of biopsies performed with sedation increased from 15.6% in 2016 to 25.5% in 2021. Saturation biopsies were nine times more likely to involve sedation than systematic biopsies (OR= 9.02, 98% CI= 8.18-9.95, p<0.001). Patients with a prior biopsy were 39% more likely to receive sedation (OR= 1.39, 98% CI= 1.35-1.43, p<0.001). MRI-guided biopsies were nearly twice as likely to involve sedation compared to non-MRI biopsies (OR= 1.98, 98% CI= 1.93-2.04, p<0.001). In 2021, the expected out-of-pocket cost for sedated biopsies was $663 USD (98% CI= $644-$682), compared to $489 USD (98% CI= $479-$498) for non-sedated procedures.</p><p><strong>Conclusion: </strong>Sedation use during prostate biopsies is steadily increasing, alongside associated patient costs. Patients undergoing saturation biopsies, MRI-guided procedures, and those with prior biopsy history were more likely to receive sedation. These findings highlight evolving patterns in biopsy practices and underscore the need to balance patient comfort with procedural cost and accessibility considerations.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668615","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":"Five-Year Outcomes of Water Vapor Therapy versus Doxazosin, Finasteride, and Combination Therapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Cohort Data from the Medical Therapy of Prostatic Symptoms (MTOPS) Trial.","authors":"Bronwyn Long, Amandip Cheema, Olivia Copelan, Cara Joyce, Marina Feffer, Kevin T McVary","doi":"10.1016/j.urology.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.016","url":null,"abstract":"<p><strong>Objective: </strong>To compare 5-year clinical and subjective treatment outcomes of water vapor thermal therapy to MTOPS trial cohorts receiving doxazosin, finasteride, or combination therapy.</p><p><strong>Methods: </strong>MTOPS subjects who received doxazosin, finasteride, combination therapy, or placebo (ClinicalTrials.gov NCT00021814) were compared to the treatment arm of a randomized controlled trial of thermal therapy using the Rezūm System (NCT01912339). Only MTOPS subjects who met criteria for the Rezūm trial were included (prostate volume 30-80 cc, IPSS ≥ 13). Inverse probability weighting by the propensity score was used to adjust for potential confounding variables. Subjective, objective, and clinical progression outcomes were compared over 5-years.</p><p><strong>Results: </strong>Symptom scores improved from baseline after thermal therapy throughout the study (∆ IPSS=-11.1 at 3 months to -9.5 at 5 years). By 5 years thermal therapy had the lowest rate of clinical progression at 4.6% while thermal therapy symptom improvement was similar to finasteride (p=0.10) and combination therapy (0.77) but remained superior to doxazosin (p=0.004) and placebo groups (p= 0.035). Objective outcomes after Rezūm were more variable throughout follow-up, with peak flow showing benefit through year 3 only, and no benefit over placebo with respect to post void residual.</p><p><strong>Conclusions: </strong>WVTT patients experienced lower rates of clinical progression at 5-years post-treatment and thus may represent a benefit compared to pharmaceutical therapy for appropriately selected patients. Additionally, a single Rezūm treatment produces symptom score improvements that are initially superior to daily long-term medication, however this advantage wanes over time.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668613","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":"Prediction Model for Detrusor Underactivity via Noninvasive Clinical Parameters in Men With Benign Prostatic Hyperplasia.","authors":"Yangyang Wu, Kaikai Lv, Yang Zhao, Guorong Yang, Xiaowei Hao, Baohui Zheng, Chao Lv, Ziyan An, Huixia Zhou, Qing Yuan, Tao Song","doi":"10.1016/j.urology.2025.07.021","DOIUrl":"10.1016/j.urology.2025.07.021","url":null,"abstract":"<p><strong>Objective: </strong>To develop a clinical prediction model for detrusor underactivity (DU) in patients with benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>A retrospective review was conducted on 546 individuals with BPH who had undergone urodynamic testing between January 2012 and May 2022. The bladder contractility index (BCI) was assessed using a pressure-flow study (PFS). Patients were categorized into DU (BCI <100, n = 196) and non-DU (BCI ≥100, n = 350) groups. Univariate logistic regression was initially performed to identify potential DU-related factors, followed by multivariate analysis to determine independent risk factors.</p><p><strong>Results: </strong>A predictive model for DU in patients with BPH was developed using the coefficient of these independent risk factors. Among the 546 cases, 196 (35.9%) were diagnosed with DU. Older age, smaller prostate volume, lower urgency symptom score, lower incomplete emptying symptom score, higher straining symptom score, and lower maximum flow rate (Qmax) were identified as independent predictors of DU in patients with BPH. The model demonstrated an area under the curve of 0.78 (95% CI, 0.74-0.82), with internal validation yielding 0.75 (95% CI, 0.74-0.75).</p><p><strong>Conclusion: </strong>We developed a predictive model that effectively estimates the DU probability in patients with BPH without requiring invasive pressure-flow study.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668617","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}