Urology最新文献

{"title":"URL-D-24-01091 - The Association between Stone Heterogenicity and the Success of SWL for High Density Upper Urinary Tract Stones.","authors":"Mathew D Sorensen","doi":"10.1016/j.urology.2024.11.017","DOIUrl":"10.1016/j.urology.2024.11.017","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668998","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 \"Trends and Safety of Same-Day Discharge for Robot-Assisted Laparoscopic Prostatectomy: a Comparison between the Pre-Pandemic and Pandemic Periods from the National Cancer Database\".","authors":"Mohammed Shahait","doi":"10.1016/j.urology.2024.11.015","DOIUrl":"10.1016/j.urology.2024.11.015","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668935","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":"Experiences with Genitourinary Syndrome of Menopause and Barriers to Vaginal Estrogen Usage Reported by a National Sample of 1500 Women.","authors":"Sabrina L Stair, Jennifer Chyu, Shazia Rangwala, Cristina J Palmer, Alvaro Lucioni, Una J Lee","doi":"10.1016/j.urology.2024.11.014","DOIUrl":"10.1016/j.urology.2024.11.014","url":null,"abstract":"<p><strong>Objective: </strong>To investigate women's experiences with genitourinary syndrome of menopause (GSM) and vaginal estrogen therapy (VET), including barriers, awareness, and knowledge, and to report current trends and findings on GSM and VET to address barriers to care.</p><p><strong>Methods: </strong>A survey on GSM and VET was posted on the ResearchMatch website. Eligible participants were women ≥ 40 years of age. Demographic information, menopausal status, current knowledge, prior experiences, and barriers associated with VET and GSM were queried. Satisfaction with their care on a 5-point Likert scale (3 coded to the neutral value with 5 being high) was assessed.</p><p><strong>Results: </strong>Respondents (n=1,505) had a mean age of 57.6 years (SD 10.8).The majority (87%) were white, 13.7% were perimenopausal, and 872 (57.9%) were post-menopausal. 999 (69%) of women reported at least one genitourinary symptom associated with menopause. Of the 323 women who received a prescription 13% did not use it due to cost and 38.4% for fear of side effects. Among current VET users, moderate to severe concern for risks listed on the package insert were reported for breast cancer (31.4%), endometrial cancer (27.2%), and cardiovascular issues (32.1%).</p><p><strong>Conclusion: </strong>The vast majority of survey respondents reported at least one symptom of GSM. VET usage was lower than reported GSM symptoms. Patient barriers to using VET include cost and fear of side effects. A quarter of women reported their symptoms were not adequately addressed by their provider. The majority of women using VET reported symptomatic improvement and that treatment was well-tolerated.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668880","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 \"Persistent Opioid Use following Artificial Urinary Sphincter Placement: A Large Claims Database Analysis\".","authors":"Alexander J Skokan","doi":"10.1016/j.urology.2024.11.013","DOIUrl":"10.1016/j.urology.2024.11.013","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668933","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":"Efficacy of symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index-29 questionnaire in assessing alpha-blocker treatment response in patients with benign prostatic hyperplasia: A prospective, multicenter, cohort study.","authors":"Arikan Ozgur, Kazan Ozgur, Arikan Mehmet Gurkan, Ucar Taha, Parpucu Alihan, Iplikci Ayberk, Cakici Mehmet Caglar, Culpan Meftun, Yildirim Asif","doi":"10.1016/j.urology.2024.11.023","DOIUrl":"https://doi.org/10.1016/j.urology.2024.11.023","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of the symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index-29 questionnaire (LURN SI-29) in assessing alpha-blocker treatment response in patients with LUTS.</p><p><strong>Methods: </strong>This prospective, non-randomised, multicentre trial included males with LUTS who visited urology outpatient clinics between January and April 2023. The most employed LUTS questionnaire is the International Prostate Symptom Score (IPSS), while the LURN SI-29 was also utilised. Prospective monitoring comprised the completion of IPSS and LURN SI-29 forms, uroflowmetry, and residual urine assessment prior to the initiation of alpha-blocker therapy and at the conclusion of the first month of treatment.</p><p><strong>Results: </strong>The study cohort comprised 135 patients. There was a significant enhancement in the mean IPSS, which decreased from 18.4 to 11.2 (p=0.001). Furthermore, the mean LURN SI-29 score exhibited a significant decline, from 37.02 to 22.4 (p=0.001). The improvement in IPSS and LURN SI-29 scores was 67.1%±54.3% and 64.2%±34.1%, respectively. Additionally, these improvements were found to be correlated (Pearson correlation coefficient=0.79, R2=0.63, p=0.001). The mean Qmax increased from 10.3 ml/s to 11.9 ml/s (p=0.001). No significant difference was identified between alpha-blocker types.</p><p><strong>Conclusion: </strong>A strong correlation was observed between LURN SI-29 and IPSS among patients with LUTS who were initiated on alpha-blocker therapy. LURN-SI-29 may be employed for the purpose of evaluating the efficacy of alpha-blocker therapy and may additionally offer insight into the domains of incontinence, post-micturition symptoms, and pain.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649063","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 \"Castration Levels of Testosterone Results in Atrophy of Androgen-Sensitive Perineal Muscles: A Potential Biomarker for Male Hypogonadism\".","authors":"Omer A Raheem, Alaeddin Barham","doi":"10.1016/j.urology.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.urology.2024.11.005","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644856","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 Impact of Testosterone Therapy on Benign Prostatic Hyperplasia in Hypogonadal Men.","authors":"Kiarad Fendereski, Joshua John Horns, Hojat Dehghanbanadaki, Claudia M Watkins, James M Hotaling","doi":"10.1016/j.urology.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.urology.2024.11.006","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the impact of testosterone therapy on the incidence of benign prostatic hyperplasia in a large cohort of hypogonadal men, and to evaluate the relationship between testosterone therapy in hypogonadal men and prostatic interventions.</p><p><strong>Methods: </strong>We used the 2011-2020 IBM MarketScan database to identify hypogonadal males above 18 years old and determine if they received testosterone therapy. ICD-9, -10, CPT, HCPCS, and NDC codes were used for diagnoses, interventions, and medications. We ran Cox proportional hazard models to determine the effect of testosterone therapy on receiving a diagnosis of benign prostatic hyperplasia and interventions. Models were adjusted for age, region, population density, and comorbidities, with testosterone therapy within the last 6 months considered a time-varying covariate.</p><p><strong>Results: </strong>In our total cohort of 882,570 hypogonadal men, 157,185 (17.8%) were diagnosed with benign prostatic hyperplasia. For the first 2.5 years after hypogonadism diagnosis, there was no significant difference in the diagnosis of prostatic hyperplasia between patients on testosterone therapy and those who were not (HR:1, 95%CI:0.98-1.01, p=0.66). However, from 2.5 years onward, men who were on testosterone therapy had a 32% higher risk of receiving a diagnosis of benign prostatic hyperplasia (HR:1.32, 95%CI:1.28-1.36, p<0.001). Hypogonadal men with benign prostatic hyperplasia who received testosterone therapy showed no significant difference in interventions compared to those who did not receive testosterone (HR:0.95, 95%CI:0.89-1, p=0.08).</p><p><strong>Conclusions: </strong>In the long term, testosterone therapy increased the risk of receiving a diagnosis of benign prostatic hyperplasia in hypogonadal men. Testosterone therapy in hypogonadal men with benign prostatic hyperplasia did not change the need for interventions.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644859","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":"Updated Research Publication Standards and Expectations for Successful Matching in Urology Residency Following Step 1 Scoring Changes.","authors":"David Musheyev, Lennox Ksido, Netanel Yomtov, Aaron Lavi, Eli Berglas, Melody Eckert, Julia Glatman, Roman Shimonov, Isaac Inoyatov, Jacob Berglas, Lakshay Khosla, Andrew G Winer","doi":"10.1016/j.urology.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.urology.2024.11.011","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the research productivity of 2024 urology residency applicants and its impact on match outcomes following the transition of the Step 1 exam to a Pass/Fail scoring system.</p><p><strong>Methods: </strong>We conducted a retrospective review of PubMed-indexed publications for 98 applicants matched to the top 25 urology residency programs, as ranked by Doximity. Metrics such as the number of publications, citations, journal impact factors, and authorship rank were analyzed. Statistical comparisons of publication rates between top-ranked and lower-ranked programs were made using independent samples t-tests.</p><p><strong>Results: </strong>The average number of publications per applicant was 5.95, with those entering top-ranked programs exhibiting higher research outputs. Most publications were found in journals like \"Urology\" and \"Urology Practice.\" A significant portion of the research was published in the final year of medical school, indicating a push for paper acceptances prior to the urology application deadline date.</p><p><strong>Discussion: </strong>The increase in research output among applicants reflects the shifting weights of factors important for residency competitiveness following the Step 1 Pass/Fail scoring changes. Early engagement and mentorship in research have been shown to increase the research output of students. The findings of this study clarify the research expectations of matching successfully into a top urology program and can be used by both medical students and program directors in the current and upcoming cycles.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640046","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":"Student Urology Conference Increases Participant Knowledge of Urology Match and Confidence in Research.","authors":"Isaac E Kim, Sai Allu, Maureen Whittelsey, Victoria Kent, Ege Gungor Onal, Christopher Nguyen, George Haleblian, Isaac Y Kim, Elias Hyams, Hsi-Yang Wu, Anthony Caldamone, Gyan Pareek","doi":"10.1016/j.urology.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.urology.2024.11.002","url":null,"abstract":"<p><strong>Objective: </strong>To study the impact of a student-specific urology conference for students considering a career in urology. The first symposium specifically for medical students interested in urology was designed to provide an opportunity to present their research, explore urological subspecialties, and network with faculty members, residents, and other students.</p><p><strong>Methods: </strong>Medical students and faculty at a U.S. medical school organized the inaugural New England Student Urology Symposium (NESUS). The conference consisted of presentations from faculty members on various urology subspecialties, invited keynote speakers from regional Urology faculty, student poster and oral presentations, a surgical skills fair, and student and faculty panels surrounding the Urology Match and impact on career decision-making. Surveys were administered both before and after the conference to assess student perspectives.</p><p><strong>Results: </strong>42 medical students attended the conference, representing 21 medical schools from 15 states across all major U.S. regions. Attending the conference was associated with increased knowledge surrounding the Urology Match for students at schools without urology clinical rotations and decreased certainty about pursuing urology as a specialty along with increased comfort with presenting research for all attendees. 100% of student attendees recommended the conference to medical students interested in urology.</p><p><strong>Conclusion: </strong>Our study demonstrates that conference attendees found NESUS to be a valuable opportunity to gain confidence in presenting research, strengthen knowledge about the match process and its competitiveness, and network with faculty, residents, and fellow students. Future student-focused conferences in urology and other specialties should be considered at the regional or national level.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640045","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":"INTEGRATING A VIRTUAL REALITY MASK IN FUNCTIONAL UROLOGICAL SURGERIES UNDER LOCAL ANESTHESIA: A PROSPECTIVE COHORT STUDY ON UTILITY AND SATISFACTION.","authors":"Paolo Geretto, Sabrina De Cillis, Luigi Candela, Thibault Germain, Nicolas Vienney, Margaux Felber, Véronique Phé","doi":"10.1016/j.urology.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.urology.2024.11.007","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the safety and efficacy of a virtual reality (VR) mask as a distraction tool during minimally invasive functional urological interventions as part of the local anesthesia protocol.</p><p><strong>Methods: </strong>This is a single-centre prospective observational pilot cohort study which included all consecutive patients undergoing intradetrusor botulinum toxin injection, sacral neuromodulation, and urethral bulking agent injection with combined anesthetic protocol composed by local anesthesia and a VR mask (Hypno VR^TM virtual reality mask, Strasbourg, France). Preoperative and postoperative evaluation included the State-Trait Anxiety Inventory (STAI) index. Intraoperatively, a 4-point Likert anxiety rating scale and a visual analog scale (VAS) pain score were assessed. Vital signs were measured preoperative and intraoperatively. Postoperatively, two questionnaires exploring patient satisfaction were administered. The evaluated outcomes were the tolerability of the device and patient's reported intraoperative pain and anxiety.</p><p><strong>Results: </strong>Thirty-nine patients were included. Mean age was 64 years. Eleven patients (28%) were affected by neurological conditions. Two patients experienced subjective discomfort. Preoperative and intraoperative mean arterial pressure was 105 and 111 mmHg (p=0.01), respectively. Preoperative and intraoperative mean heart rate was 72 and 75 bpm (p=0.12), respectively. Preoperative and postoperative STAI index were 34.8+-10 and 32.8+-10.3 (p=0.88). Mean Likert anxiety scale value was 2.2+-1.1, mean intraoperative VAS score was 5.3+-2.5. Thirty-four (87%) patients declared themselves satisfied with the surgical procedure and 36 (92.3%) patients would have recommended the same procedure to a relative.</p><p><strong>Conclusions: </strong>Virtual reality mask may play a role in reducing pain and anxiety in minimally-invasive functional urological interventions.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640017","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}