Urology最新文献

{"title":"Exploring the Impact of Mental Health on PSA Screening: Insights from a Population-Based Survey.","authors":"Andrea Piccolini, Zhiyu Qian, Stephan M Korn, Filippo Dagnino, Klara Pohl, Hanna Zurl, Yvonne Lei, Nora Y Osman, Giovanni Lughezzani, Nicolò M Buffi, Quoc-Dien Trinh, Alexander P Cole","doi":"10.1016/j.urology.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.016","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between mental health status and prostate-specific antigen (PSA) screening, given that poor mental health may reduce engagement in preventive health behaviors.</p><p><strong>Methods: </strong>We analyzed data from the 2018 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) surveys, including men aged 50-69 years without history of prostate cancer. The primary outcome was self-reported PSA screening in the past two years. Poor mental health was defined as at least 14 days of self-reported poor mental health or a depressive disorder diagnosis. Covariates included socio-demographic variables, chronic comorbidities, and healthcare access. Logistic regression assessed associations between mental health, PSA screening, and covariates.</p><p><strong>Results: </strong>A total of 114,972 men were included, representing a weighted population of 30.5 million. Of them, 81.9% and 18.1% had good and poor mental health, respectively. The overall PSA screening rate was 28.2%. Men with good mental health were more likely to undergo PSA screening (29.3% vs 23.2%; p<0.001). Poor mental health was associated with 10% lower odds of PSA screening (aOR: 0.90 [0.83-0.98]). Higher adherence was observed among older participants (aOR: 2.54), with higher education levels (aOR: 1.95), or married (aOR: 1.21). Having at least one personal doctor (aOR: 2.86) was a strong predictor of PSA screening.</p><p><strong>Conclusions: </strong>Men with poor mental health are less likely to undergo PSA screening. Addressing mental health barriers is essential to improve preventive care. Integrated care models with mental health support may reduce disparities and enhance prostate cancer outcomes in this population.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302948","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":"Prevalence, Risk Factors, and Coping Strategies for Burnout Among Pediatric Urologists.","authors":"Nicolette G Payne, Daniel Salevitz, Natalie Dvorak, Amanda North, Gwen M Grimsby","doi":"10.1016/j.urology.2025.06.025","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.025","url":null,"abstract":"<p><strong>Objective: </strong>To determine the current prevalence of burnout in pediatric urologists, to identify risk factors associated with higher levels of burnout, and to identify coping strategies among pediatric urologists.</p><p><strong>Methods: </strong>The Maslach Burnout Inventory (MBI) and an anonymous survey of demographic and practice characteristics were distributed electronically to pediatric urologists through the Society of Pediatric Urology. The MBI is a standardized, validated questionnaire comprised of three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). As per prior literature, higher scores in EE (>27) and/or DP (>10) were defined as high burnout. Independent variables of demographic and practice characteristics were compared between urologists with high versus low to moderate levels of burnout with t tests and Fisher's exact tests.</p><p><strong>Results: </strong>The survey response rate was 203/674 (30%). Mean age of respondents was 50 years, 66% were male, and the average number of years in practice was 15.6. The mean MBI scores were 22.6 for EE, 7.4 for DP, and 38.5 for PA. Overall, 43% of pediatric urologists met criteria for high burnout compared to 25.5% in the 2016 AUA census. Univariate analysis revealed three factors significantly associated with high burnout: younger age, female gender, and hours worked per week.</p><p><strong>Conclusions: </strong>The results of this study suggest an increased prevalence of burnout among pediatric urologists since the 2016 AUA census, particularly in younger and female urologists. Identification of these risk factors is important to mitigate burnout and maintain the already strained urology workforce.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302950","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":"Delayed Urinary Retention After Holmium Laser Enucleation of Prostate.","authors":"Maithili Gopalakrishnan, Anastasija Useva, Raj Kumar, Adam Novak, Scott Wiener","doi":"10.1016/j.urology.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.018","url":null,"abstract":"<p><strong>Objective: </strong>To identify modifiable perioperative risk factors associated with delayed urinary retention (DUR) that occurs after a successful same-day trial of void (SDTOV) in patients undergoing holmium laser enucleation of prostate (HoLEP).</p><p><strong>Methods: </strong>Our institution prospectively maintains an IRB-approved single surgeon database of HoLEP procedures from which we identified patients with DUR after passing SDTOV. Exclusion criteria included the first 50 cases (due to surgeon's learning curve), patients with failed SDTOV, and clot retention. Using SPSS 26 statistical software, we analyzed various peri-operative factors in association with our primary outcome, DUR, using unpaired t-tests for continuous variables and chi-squared analysis for categorical variables. Multivariate logistic regression was used to assess several preoperative and operative variables in association with DUR (p<0.05 as significant).</p><p><strong>Results: </strong>500 HoLEPs were performed from Jan 2020-Aug 2024. 18 (5.17%) of the 348 patients included had DUR. We found no significant differences in age, BMI, ASA, comorbidities, preoperative prostate size, or medication use between patients who did and did not have DUR. On multivariate logistic regression, intraoperative urethral dilation (25.8% cases) and postoperative continuous bladder irrigation (CBI) (7.7% cases) were significantly associated with DUR (p<0.05).</p><p><strong>Conclusions: </strong>Intraoperative urethral dilation and postoperative CBI were significant predictors of non-clot DUR. Therefore, surgeries involving these contributors warrant additional postoperative patient counseling and consideration of discharge with catheter to decrease morbidity and cost from unplanned encounters for catheter replacement.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302947","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 \"Telehealth Use and Barriers in Non-metropolitan Clinic Populations\".","authors":"Xiaoqing Hu","doi":"10.1016/j.urology.2025.06.022","DOIUrl":"10.1016/j.urology.2025.06.022","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302949","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 \"Electronic Residency Application Service Application Fees in Surgical Subspecialties: A Barrier to a Diverse Healthcare Workforce?\"","authors":"Abdul-Jawad J Majeed, Dennis Head, Jay D Raman","doi":"10.1016/j.urology.2025.06.019","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.019","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295031","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":"Disparities in Access to High Volume Centers for Muscle Invasive Bladder Cancer and its Association With Treatment Patterns and Outcomes.","authors":"Savannah Starr, Saam Kazemi, Precious Moman, Lin Lin, J J Zhang, Karim Chamie","doi":"10.1016/j.urology.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.021","url":null,"abstract":"<p><strong>Objective: </strong>To investigate access to high volume centers (HVCs) for non-metastatic muscle-invasive bladder cancer (MIBC) and assesses implications of disparities on treatment outcomes. We hypothesized that socially disadvantaged patients would have limited access to HVCs, contributing to observed outcome disparities.</p><p><strong>Methods: </strong>We conducted a retrospective analysis using the National Cancer Database (NCDB) from 2004 to 2020 of patients with non-metastatic MIBC. We categorized treatment facilities into high-volume centers (HVCs), intermediate-volume centers (IVCs), and low-volume centers (LVCs) based on annual case volumes. We analyzed demographic, socioeconomic, and insurance-related factors influencing access to HVCs through multivariable logistic regression. Treatment modalities, perioperative outcomes, and overall survival were compared across facility volume cohorts.</p><p><strong>Results: </strong>The majority of patients (57.2%) were treated at HVCs, with significant demographic disparities observed. Black patients (OR 0.68, p<0.001) and those from lower socioeconomic backgrounds were less likely to receive care at HVCs. Patients at HVCs experienced higher rates of radical cystectomy (OR 1.67, p<0.001) and neoadjuvant chemotherapy (OR 1.76 p<0.001) with better perioperative outcomes, including reduced readmissions (OR 0.78, p<0.001), less prolonged hospital stays (OR 0.76, p<0.001), and improved overall survival (5-year survival rates: HVCs 37.7% vs. LVCs 30.1%, p<0.001).</p><p><strong>Conclusion: </strong>Our findings reveal substantial disparities in access to HVCs for MIBC treatment, particularly affecting Black and economically disadvantaged patients. HVCs have significantly improved outcomes and survival, highlighting the need for systemic interventions to improve access to high quality cancer care.</p><p><strong>Data availability statement: </strong>The data used in this study are available from the National Cancer Database (https://www.facs.org/quality-programs/cancer/ncdb).</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295030","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 Editorial Comment on \"Benign Non-Infectious Scrotal Dermatoses: An Overview.","authors":"Katherine L Wang, James H Keeling Iii, Miguel A Aristizabal, Thais P Pincelli, Elisha M Singer","doi":"10.1016/j.urology.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.020","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295033","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":"Understanding the Experience of Receptive Anal Intercourse in Patients With Chronic Pelvic Pain Syndrome.","authors":"Jonathan A Balcazar, Thomas W Gaither, Myles Anderson, Marcia M Russell, Mark S Litwin","doi":"10.1016/j.urology.2025.06.015","DOIUrl":"10.1016/j.urology.2025.06.015","url":null,"abstract":"<p><strong>Objective: </strong>To identify chronic pelvic pain syndrome (CPPS) correlates in receptive anal intercourse (RAI)-engaging individuals and their association with the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) scores. CPPS, or category III prostatitis, causes pelvic pain, urinary symptoms, and sexual dysfunction. Its etiology remains unclear but may involve visceral crosstalk, where dysfunction in one pelvic organ affects another.</p><p><strong>Methods: </strong>We conducted an online cross-sectional survey (July 2022-January 2023) of individuals assigned male at birth who engaged in RAI in the past six months. Participants completed the NIH-CPSI and Anorectal Sexual Function Index to assess pain, urinary, and bowel symptoms. Mental health symptoms, childhood trauma, and urologic, gastrointestinal, and anorectal conditions were also assessed. NIH-CPSI severity groups: non-mild (<10), moderate (10-18), and severe (>18). Analyses included Kruskal-Wallis and chi-squared tests.</p><p><strong>Results: </strong>Among 408 participants, 117 (28.7%) had moderate/severe CPPS. Higher NIH-CPSI scores correlated with decreased pleasure (P = .001), increased pain (P <.001), and greater urinary/bowel symptoms. Lower RAI exposure (<50 times) correlated with higher NIH-CPSI scores (P = .01). Comorbid urologic, gastrointestinal, and anorectal conditions, childhood trauma, and mental health symptoms were associated with CPPS severity (P <.001).</p><p><strong>Conclusion: </strong>These findings highlight the interplay between CPPS severity, sexual function, and comorbid conditions in RAI-engaging individuals. Visceral crosstalk may contribute to anorectal symptom overlap, while mental health and childhood trauma align with the central sensitization models of chronic pain. The inverse relationship with CPPS severity suggests pelvic floor dysfunction or desensitization mechanisms; thus, multidimensional management is essential.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295035","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 Editorial Comment on \"Incorporating Intra-Operative Education Into Ergonomics Training for Endourology Cases: A Pilot Study\".","authors":"Meghan F Davis, Rachael Sussman","doi":"10.1016/j.urology.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.001","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295034","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 \"Sex and Age Variation for Nephrolithiasis Risk Factors on 24-Hour Urine Metabolic Evaluation: A Real-world Single-center Retrospective Analysis\".","authors":"Mingwen Huang","doi":"10.1016/j.urology.2025.06.017","DOIUrl":"10.1016/j.urology.2025.06.017","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295032","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}