IF 2.1 3区医学

Urology Pub Date : 2025-03-18 DOI: 10.1016/j.urology.2025.03.021

Moretto Stefano, Traxer Olivier, Quarà Alberto, Madden Aideen, Cabrera Johan, Zorzi Federico, Bravo-Balado Alejandra, Corrales Mariela, Candela Luigi, Berthe Laurent, Doizi Steeve, Panthier Frederic

引用次数: 0

Editorial Comment on "Characterization of Newborn Circumcision Revisions and Complications among Privately Insured Boys in the United States between 2010 and 2022".

IF 2.1 3区医学

Urology Pub Date : 2025-03-18 DOI: 10.1016/j.urology.2025.03.024

John H Makari

引用次数: 0

State Laws & Insurance Coverage for Male Infertility.

IF 2.1 3区医学

Urology Pub Date : 2025-03-18 DOI: 10.1016/j.urology.2025.03.025

Aleksandar Popovic, Kunj Jain, Ernest Gillan, Meher Pandher, Amjad Alwaal

{"title":"State Laws & Insurance Coverage for Male Infertility.","authors":"Aleksandar Popovic, Kunj Jain, Ernest Gillan, Meher Pandher, Amjad Alwaal","doi":"10.1016/j.urology.2025.03.025","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.025","url":null,"abstract":"Objective: To assess coverage of male infertility in state laws. Infertility is experienced by 12% of couples, unfortunately, however, infertility treatments are expensive and infrequently covered by insurance. Furthermore, many states lack explicit laws on fertility coverage.Methods: The National Conference of State Legislatures and individual state legislature websites were used to assess fertility coverage. These were queried for health insurance mandates or fertility coverage by evaluating healthcare related legislation.Results: Less than half (21/50) of states require coverage. Amongst these, there is substantial variability in how infertility is defined. A minority (5/21) use the definition of 6 or 12 months of unprotected intercourse in those over or under age 35, respectively, without conception. Others have no length of time stated (7/21) or it ranges from 1 to 5 years (9/21). Some states restrict coverage to specific groups, such as NJ (coverage if under 46 years old). While 19 states include female infertility coverage, only 13 include coverage for males. Lastly, only 6 states include explicit legislation and criteria for treatment of male infertility not related to iatrogenic causes.Conclusions: Male infertility coverage is lacking across the United States. Male exclusion places greater burden on females, which may lead to missed opportunities to diagnose medical conditions, and miss reversible causes of infertility. Despite recommendations that both partners undergo infertility evaluations, only 6 states have legislation for insurance coverage of non-iatrogenic infertility. Practitioners must be well-acquainted with laws and stay up-to-date in the ever changing legislative landscape of infertility care.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670870","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

ENAuthor reply to editorial comment on "Comparative Efficacy of Dorsal-Onlay and Ventral-Inlay Buccal Mucosal Graft Urethroplasty in Female Urethral Stricture: A Randomized Clinical Trial".

IF 2.1 3区医学

Urology Pub Date : 2025-03-18 DOI: 10.1016/j.urology.2025.03.020

Swarnendu Mandal, Prasant Nayak

引用次数: 0

Editorial Comment: Failure of Prenatal Ultrasonography to Identify Classic Bladder Exstrophy in a Heavily Screened Population" (# URL-D-24-02478R1).

IF 2.1 3区医学

Urology Pub Date : 2025-03-18 DOI: 10.1016/j.urology.2025.03.023

Kelly T Harris, Mariana L Meyers, Duncan T Wilcox

引用次数: 0

Renal Trauma Management: A Century of Evolution from 'Stabbing in the Dark' to the Radiographic Revolution.

IF 2.1 3区医学

Urology Pub Date : 2025-03-17 DOI: 10.1016/j.urology.2025.02.038

Emily C Hacker, Taylor C Noakes, Jack W McAninch, Benjamin N Breyer

{"title":"Renal Trauma Management: A Century of Evolution from 'Stabbing in the Dark' to the Radiographic Revolution.","authors":"Emily C Hacker, Taylor C Noakes, Jack W McAninch, Benjamin N Breyer","doi":"10.1016/j.urology.2025.02.038","DOIUrl":"https://doi.org/10.1016/j.urology.2025.02.038","url":null,"abstract":"Objective: To outline how practices have shifted over the past 100 years while highlighting some of the key figures who have influenced the field. The management of renal trauma has long been an evolving and at times controversial field of study within urology. Though surgical exploration and nephrectomy were more common in the past, practice has shifted to observation and avoidance of intervention in most cases. Over the past century, technological advancements have given urologists and trauma surgeons the tools to improve clinical outcomes, which we outline in the following essay.Methods: A broad literature review was performed of archival material and medical journal articles that included both primary and secondary documents related to renal trauma management and advances in relevant technology. Primary subject interviews were conducted with subject matter experts including Dr. Jack McAninch and Dr. Jeremy B. Myers.Results: The earliest days of renal trauma were marked by conservatism that was largely a consequence of the few options available for evaluation and worthwhile intervention. As surgical techniques developed and the role of exploratory laparotomy became established, there was considerable debate over how aggressive surgical management should be. Alongside these operative advances, the evolution of radiographic techniques became one of the most impactful aspects in renal trauma management, culminating with the introduction of CT and subsequent grading scales.Conclusions: Over the past century, urologists have progressed from stabbing in the dark without imaging or clinical consensus, to managing renal trauma with high quality imaging and evidence-based guidelines.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664661","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

Characterization of the Pheochromocytoma-Predominant Subgroup of von Hippel-Lindau Disease.

IF 2.1 3区医学

Urology Pub Date : 2025-03-14 DOI: 10.1016/j.urology.2025.03.006

Julie R Solomon, Keith A Lawson, Cathy D Vocke, Laura S Schmidt, Christopher J Ricketts, W Marston Linehan, Mark W Ball

{"title":"Characterization of the Pheochromocytoma-Predominant Subgroup of von Hippel-Lindau Disease.","authors":"Julie R Solomon, Keith A Lawson, Cathy D Vocke, Laura S Schmidt, Christopher J Ricketts, W Marston Linehan, Mark W Ball","doi":"10.1016/j.urology.2025.03.006","DOIUrl":"10.1016/j.urology.2025.03.006","url":null,"abstract":"Objective: To define a classification schema for von Hippel-Lindau (VHL) patients who have a pheochromocytoma predominant phenotyope.Materials and methods: VHL patients who underwent adrenalectomy with pathology-proven pheochromocytoma at our institution were included. We defined pheochromocytoma-predominant VHL a priori as patients with one or more of the following traits: early onset [age at first pheochromocytoma below the cohort's median age (28.2years)], family history of pheochromocytomas, multiple pheochromocytomas, and paraganglioma(s). Patients with pheochromocytoma-predominant disease were compared to the remaining cohort to determine differences in genotype and phenotype.Results: One-hundred thirty-nine VHL patients were examined. Preliminary analysis showed that three characteristics (early onset, family history, and multiple pheochromocytomas) were associated. Having paraganglioma(s) did not correlate with the other factors, so it was excluded from the definition of pheochromocytoma-predominant disease. The majority of our patients (110/139, 79%) met the final definition. Pheochromocytoma-predominant patients were less likely to have most additional VHL tumor types, including renal cell carcinoma (P<.001) whereas they were more likely to have missense mutations (P<.001) than the remaining cohort. Overall, pheochromocytoma-predominant patients were most likely to have 0 (P<.001) or 1 (P=.008) extra-adrenal tumor types while non-pheochromocytoma-predominant patients were most likely to have 4 (P=.02) or 5 (P=.02).Conclusion: Pheochromocytoma-predominant VHL patients are phenotypically distinct from their non-pheochromocytoma-predominant counterparts and are significantly less likely to have more than one other VHL manifestation, including renal carcinoma.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639776","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

Can ultrasound guided fluoroscopy efficiently reduce radiation time & dose in mini-PCNL in children, a prospective randomized trial.

IF 2.1 3区医学

Urology Pub Date : 2025-03-13 DOI: 10.1016/j.urology.2025.03.012

Amr K Salama, Mahmoud A ElSabbagh, Ahmed M Fahmy, Mohamed Youssif, Haytham Badawy, Assem Ghozlan, Waleed A Dawood

{"title":"Can ultrasound guided fluoroscopy efficiently reduce radiation time & dose in mini-PCNL in children, a prospective randomized trial.","authors":"Amr K Salama, Mahmoud A ElSabbagh, Ahmed M Fahmy, Mohamed Youssif, Haytham Badawy, Assem Ghozlan, Waleed A Dawood","doi":"10.1016/j.urology.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.012","url":null,"abstract":"Objective: To assess how much can fluoroscopy assisted US guided puncture reduce radiation exposure in PCNL, and can it achieve equivalent results compared to the traditinoal fluorosocpy technique in PCNL.Methods: From July 2022 to August 2023, 50 patients receiving mini-percutaneous nephrolithotomy (mini-PCNL) were included in a prospective randomized study. Two groups of twenty-five patients each were formed. Those in Group A received fluoroscopy-only guided (FG) puncture, whereas those in Group B received fluoroscopy assisted ultrasound guided (FUSG) puncture. Analysis was done on the following variables: stone-free rate, complication rate, fluoroscopy time, and demographic data.Results: Mean age in group A compared to group B was 7.24 ± 3.72 vs. 8.0 ± ±3.77 years respectively. The addition of ultrasonic guiding resulted in a considerable reduction in fluoroscopy duration, from 157.9 ± 68.54 seconds in group A to 29.44 ± 17.01 seconds in group B (p < 0.05). The radiation dosage was significantly lower in group B (6.07 ± 3.57) mGy compared to group A (32.35 ± 13.79) mGy (p < 0.05). In group A, the time to puncture was 136.6 ± 50.78 (sec), but in group B, it was 52.20 ± 33.20 (sec) (p < 0.05). The universal stone-free rate was 95.3%, with no discernible statistical trend. Group A's complications rate was 16%, while group B reported complication rate of 12%, with no statistically significant difference (p 0.653).Conclusion: fluoroscopy-assisted ultrasound guidance in Mini-PCNL is a safer and more effective approach than fluoroscopy alone in our experince.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633647","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

Advancing Artificial Intelligence in Clinical Medicine: From Feasibility to Impact.

IF 2.1 3区医学

Urology Pub Date : 2025-03-13 DOI: 10.1016/j.urology.2025.03.009

Laura Davis, Michael Lesgart, Austin Thompson, Shivaram Cumarasamy, Kit Yuen, Danly Omil-Lima

引用次数: 0

Editorial Comment on "Genitourinary Fellowship for Family Medicine Physicians". 关于 "全科医生泌尿生殖系统奖学金 "的编辑评论。

IF 2.1 3区医学

Urology Pub Date : 2025-03-12 DOI: 10.1016/j.urology.2025.03.010

Petar Bajic, Mark Paulos

引用次数: 0

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