IF 2.1 3区医学

Urology Pub Date : 2025-07-17 DOI: 10.1016/j.urology.2025.07.008

Sonia Guerin, Feras Alhalabi, Kevin Lutz, Philippe Zimmern

{"title":"Impact of previous pelvic organ prolapse repair on outcomes of robotic-assisted mesh sacrocolpopexy.","authors":"Sonia Guerin, Feras Alhalabi, Kevin Lutz, Philippe Zimmern","doi":"10.1016/j.urology.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.008","url":null,"abstract":"Objective: To assess the impact of previous pelvic organ prolapse (POP) surgery on the outcomes of robotic-assisted mesh sacrocolpopexy (RASC) in post-hysterectomy women.Methods: Following IRB approval, a retrospective review of a prospectively-followed cohort of post-hysterectomy women who underwent a RASC for symptomatic multi-compartment prolapse was performed by an investigator not involved in the clinical care of these patients. The cohort was stratified based on history of prior POP repair, as first line repair (FR) and second line repair (SR). Success was defined by a composite of no report of recurrent vaginal bulge, no prolapse beyond the hymen on examination, and no retreatment for prolapse. Secondary outcomes included additional surgeries for prolapse, Clavien-Dindo peri-operative complications, and Kaplan-Meier time interval to recurrent prolapse surgery.Results: Between 2010 and 2020, 87 patients underwent RASC; 35 as FR and 52 as SR. Demographics were similar in each group. Overall, all three components of success definition were met by 82% of patients (29/35) in FR group, and 73% (38/52) in the SR group (p=0.31) at median follow-up of 42 (range: 20-81) months and 61 (range: 22-116) months, respectively. Additional POP surgery was performed on 6% in the FR group and 12% in the SR group (p=0.3). Grade ≥2 complications were significantly more frequent in the SR group, with 12 cases, compared to two cases in the FR group (p=0.04).Conclusion: A history of prior POP repair was not significantly associated with an increased POP recurrence rate after RASC, but had a higher perioperative morbidity.","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":"144668614","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

Use of the pediatric cystoscope for adult ureteroscopy. 儿童膀胱镜在成人输尿管镜检查中的应用。

IF 2.1 3区医学

Urology Pub Date : 2025-07-16 DOI: 10.1016/j.urology.2025.07.024

Hannah S Thomas, Lauren Lin, Noah Stern, Sender Herschorn

{"title":"Use of the pediatric cystoscope for adult ureteroscopy.","authors":"Hannah S Thomas, Lauren Lin, Noah Stern, Sender Herschorn","doi":"10.1016/j.urology.2025.07.024","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.024","url":null,"abstract":"Objective: To re-introduce the versatility of the pediatric cystoscope, we aimed to synthesize the origins of ureteroscopy and outline our experience utilizing the instrument for the diagnosis and treatment of ureteral pathology.Methods: We reviewed published literature for historical and modern-day uses of the pediatric cystoscope for ureteroscopy. In addition, we described our experience manoeuvring the scope in common patient scenarios and use this to discuss the pros and cons of this tool for ureteroscopy.Results: In the 1970s, the pediatric cystoscope gave rise to diagnostic and therapeutic ureteroscopy as documented by historical case series. With the advent of longer and flexible ureteroscopy instruments, the pediatric cystoscope became seemingly less valuable for this procedure. However, as described using multiple case examples, the pediatric cystoscope can be a useful instrument for the investigation and treatment of distal ureteral pathology including 1-2cm tumors, strictures and stones. This is primarily due to the tool's ergonomic advantage, tolerability under local anesthesia and manipulation into small spaces.Conclusions: Reviewing the historical origins of ureteroscopy reintroduces the urology community to the value of the pediatric cystoscope for the diagnosis and treatment of distal ureteral pathology, particularly in women. The pediatric cystoscope can be a useful instrument for all urologists' armamentarium.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668618","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

"Utility and Perspectives of Mobile Health Applications used in Postoperative Care after Urological Surgery". “移动医疗应用在泌尿外科术后护理中的效用和前景”。

IF 2.1 3区医学

Urology Pub Date : 2025-07-16 DOI: 10.1016/j.urology.2025.07.017

Jian Ning Jan Hoe, Dillon Christopher Yong Jie Teo, Wei Zheng So, Ho Yee Tiong

引用次数: 0

Outcomes of Continent Catheterizable Channels Created in Adults. 成人建立大陆导管通道的结果。

IF 2.1 3区医学

Urology Pub Date : 2025-07-16 DOI: 10.1016/j.urology.2025.07.023

Kostantinos E Morris, Ramzy Burns, Victoria Snook, Rachel Gross, Cameron Edwards, Matthew Mellon

{"title":"Outcomes of Continent Catheterizable Channels Created in Adults.","authors":"Kostantinos E Morris, Ramzy Burns, Victoria Snook, Rachel Gross, Cameron Edwards, Matthew Mellon","doi":"10.1016/j.urology.2025.07.023","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.023","url":null,"abstract":"Objectives: To describe the long-term outcomes of adults undergoing continent catheterizable channel (CCC) procedures for bladder dysfunction of various pathologies at our institution.Methods: A retrospective chart review of all patients who underwent CCC procedure at our institution from March 2013 to February 2024 was performed. Data on patient demographics, medical history, perioperative details, and postoperative complications was reported. The primary outcome was freedom from re-operation, classified based on need for revision. Secondary outcomes were long-term catheterization of channel, based on use of channel at longest-term follow-up (median follow-up of 61 months) and leakage from channel.Results: Forty-four total patients were identified as having CCC creations at our institution. Median age was 47 (range 18-79) years. The primary indications for CCC creation were neurogenic bladder in 22/37 (59.5%) cases and refractory incontinence in 8/37 (21.6%) cases. Long-term complications of recurrent urinary tract infections were present in 6/37 (18.2) cases, and incontinence per urethra was present in 6/37 (18.2) cases. Notably, continued use of the CCC at longest-term follow-up was 28/37 (75.7%) patients.Conclusions: There is limited data regarding long-term outcomes in adult patients who underwent CCCs, as most data exists in pediatrics. This study is the largest adult-focused study to date describing long-term outcomes for adults undergoing these procedures. With future large-volume studies assessing both quality of life and procedure alternatives, we believe that pre-operative counseling and procedure selection can lead to improved patient selection and overall satisfaction.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668616","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

Chylous Leakage After Retroperitoneal Minimally Invasive Surgery: A Multi-institutional Analysis of Risk Factors, Treatment Course, and Surgical Intervention. 腹膜后微创手术后乳糜漏：多机构的危险因素、治疗过程和手术干预分析。

IF 2.1 3区医学

Urology Pub Date : 2025-07-15 DOI: 10.1016/j.urology.2025.07.018

Toru Kanno, Go Kobori, Ryoichi Saito, Masashi Kubota, Masaaki Imamura, Toshiya Akao, Hitoshi Yamada

{"title":"Chylous Leakage After Retroperitoneal Minimally Invasive Surgery: A Multi-institutional Analysis of Risk Factors, Treatment Course, and Surgical Intervention.","authors":"Toru Kanno, Go Kobori, Ryoichi Saito, Masashi Kubota, Masaaki Imamura, Toshiya Akao, Hitoshi Yamada","doi":"10.1016/j.urology.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.018","url":null,"abstract":"Objectives: To clarify the management approach for chylous leakage after retroperitoneal minimally invasive surgeries by investigating risk factors and clinical course with a video of the case requiring surgical intervention.Methods: This retrospective study included 1258 patients who underwent minimally invasive retroperitoneal surgeries at four Japanese institutions between 2010 and 2023. We analyzed the risk factors for the onset of postoperative chylous leakage and reviewed the clinical courses in patients with chylous leakage, with a detailed evaluation of cases requiring surgical intervention.Results: Chylous leakage occurred exclusively on the left in 2.1% (27/1258) of cases. It was associated with lymph node dissection (n = 22) or excessive hilar dissection around the left renal pedicle (n = 5). Multivariate analysis identified left-sided surgery and lymph node dissection as significant risk factors. Conservative management, including dietary therapy with or without octreotide, was effective in 25 cases (94%). However, two cases (6%) required surgical repair for persistent chylous leakage. In both cases, preoperative ingestion of fatty substances facilitated accurate intraoperative identification of the leakage site, allowing successful laparoscopic closure.Conclusion: Chylous leakage is a notable postoperative complication of para-aortic lymph node dissection and extensive left hilar dissection during minimally invasive retroperitoneal surgeries. Although conservative management is effective in most cases, laparoscopic repair with preoperative fatty substance administration is a viable option for refractory cases.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660394","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

Reply to Letter to the Editor on "Experiences with Genitourinary Syndrome of Menopause and Barriers to Vaginal Estrogen Usage Reported by a National Sample of 1500 Women". 关于“全国1500名妇女报告的绝经期泌尿生殖系统综合征的经历和阴道雌激素使用障碍”致编辑的回信。

IF 2.1 3区医学

Urology Pub Date : 2025-07-15 DOI: 10.1016/j.urology.2025.07.005

Una J Lee, Sabrina Stair

引用次数: 0

Cannabis Use is Associated with Lower Urinary Tract Symptoms in Pediatric Patients - A Large Claims Database Study. 大麻使用与儿科患者下尿路症状有关——一项大型索赔数据库研究

IF 2.1 3区医学

Urology Pub Date : 2025-07-15 DOI: 10.1016/j.urology.2025.07.014

Aurora J Grutman, Mohammad Elmojtaba Gumma, Nicole Page, Andrew T Gabrielson, Marisa Clifton, Heather DiCarlo

{"title":"Cannabis Use is Associated with Lower Urinary Tract Symptoms in Pediatric Patients - A Large Claims Database Study.","authors":"Aurora J Grutman, Mohammad Elmojtaba Gumma, Nicole Page, Andrew T Gabrielson, Marisa Clifton, Heather DiCarlo","doi":"10.1016/j.urology.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.014","url":null,"abstract":"Objective: To investigate whether cannabis use disorder (CUD) is associated with the diagnosis of lower urinary tract symptoms (LUTS) in pediatric patients.Methods: This retrospective cohort study queried the TriNetX Research Network for male and female patients under 18 years of age with or without CUD. Propensity-score matching was conducted matching for demographic factors and comorbidities associated with LUTS. The primary outcomes were new diagnoses of all-cause LUTS, pelvic pain, overactive bladder (OAB), dysuria, or urinary tract infection (UTI) among patients with CUD compared to controls.Results: We identified 4,859,819 male (12,0-99 CUD, 4,847,720 control) and 4,274,461 female (12,349 CUD, 4,262,112 control) patients for inclusion. After propensity-score matching, there was 11,840 male and 11,810 female patients in each arm with median ages of 15.6 and 15.5 years, respectively. At 5 years follow up, significant increases in new diagnoses of pelvic pain (OR 2.3 [95% CI 1.8-2.9], p<0.01), OAB (OR 1.6 [95% CI 1.9-2.7], p<0.01), dysuria (OR 1.2 [95% CI 1.1-1.5], p=0.01), and UTI (OR 1.8 [95% CI 1.5-2.1], p<0.01) were observed among female CUD patients compared to controls. At 5 years follow up, significant increases in new diagnoses of pelvic pain (OR 3.8 [95% CI 2.4-5.9], p<0.01), dysuria (OR 1.4 [95% CI 1.1-1.8], p=0.02), and UTI (OR 1.7 [95% CI 1.2-2.6], p<0.01) were observed in male CUD patients compared to controls.Conclusion: We observed significant increases in first-time LUTS diagnoses in pediatric patients with CUD compared to matched controls. Further research into cannabinoids' impact on urinary tract and pelvic floor function is warranted.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660393","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

Variability in accessibility of residency parental leave policies across surgical specialties. 外科专科住院医师产假政策可及性的可变性。

IF 2.1 3区医学

Urology Pub Date : 2025-07-15 DOI: 10.1016/j.urology.2025.07.015

Avani Desai, Taylor Stivali, Cordelia Muir, Emma Bethel, Katharine Michel, Angela Smith

{"title":"Variability in accessibility of residency parental leave policies across surgical specialties.","authors":"Avani Desai, Taylor Stivali, Cordelia Muir, Emma Bethel, Katharine Michel, Angela Smith","doi":"10.1016/j.urology.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.urology.2025.07.015","url":null,"abstract":"Objective: To compare the public availability of residency parental leave policies across surgical specialties and identify factors associated with policy availability.Methods: All ACGME-accredited, non-military residency programs in the United States across ten surgical specialties were examined. Parental leave policies and program characteristics were collected from program and institutional websites. Fisher's exact and Chi-square tests assessed differences in availability of program-specific and of any parental leave policies, respectively. Multivariable logistic regression examined associations between program characteristics and policy availability.Results: Program-specific parental leave policies were rarely publicly available (0-11%), with the highest availability in urology. Institutional policies were more frequently available (58-83%), but 14-38% of programs lacked any identifiable policy (on either program or institutional websites). Policy availability varied significantly by specialty (p<0.001). Across all specialties, larger program size, a higher proportion of female faculty, and unionization were significantly associated with the presence of any parental leave policy (on either program or institutional websites). Program-specific policy availability was independently associated with location in the South and larger program size. No significant associations were observed specific to urology.Conclusions: Though urology programs offer better accessibility to residency parental leave policies as compared to other surgical specialties, specific policies remain difficult to identify online. While our findings reflect publicly available information and not actual policy presence, they highlight an important opportunity for programs to improve transparency, thereby promoting equity in residency training and trainee well-being.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660398","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 "Long-term Trends in Bladder Management Strategies in Females Following Spinal Cord Injury". 关于“女性脊髓损伤后膀胱管理策略的长期趋势”的评论。

IF 2.1 3区医学

Urology Pub Date : 2025-07-15 DOI: 10.1016/j.urology.2025.07.011

George E Koch, Iryna Crescenze, Hiren V Patel

引用次数: 0

Editorial Comment on "Development and External Validation of a Local Pelvic Recurrence Risk Score After Radical Cystectomy: Identifying the Ideal Candidate for Adjuvant Radiation Clinical Trials". 编辑评论“根治性膀胱切除术后局部盆腔复发风险评分的发展和外部验证：确定辅助放疗临床试验的理想候选者”。

IF 2.1 3区医学

Urology Pub Date : 2025-07-15 DOI: 10.1016/j.urology.2025.07.012

Michael W Bacchus, Shawn Dason

引用次数: 0

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