Urology最新文献

{"title":"Association of HRQOL with Symptom Patterns in an Online Cohort of Patients with Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Anthony Galvez, Paige Kuhlmann, Margot Barker, Andrew Chen, Victoria Scott, Karyn Eilber, Jennifer Anger","doi":"10.1016/j.urology.2025.06.054","DOIUrl":"https://doi.org/10.1016/j.urology.2025.06.054","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the differences in symptom patterns and management between individuals with IC/BPS who have high vs low self-reported health related quality of life (HRQOL).</p><p><strong>Methods: </strong>An anonymous 40-question online survey assessed IC/BPS patients' symptoms, triggers, management strategies, and comorbidities. Recruitment was through the Interstitial Cystitis Association's Facebook page. HRQOL was rated on a 0-10 Likert scale, grouping respondents into low-impact (0-3), intermediate (4-6), and high-impact (7-10). Univariate analysis included chi-square, Fisher's exact test, and t-tests.</p><p><strong>Results: </strong>Among 451 respondents, 53 (12%) reported low disease impact, while 279 (62%) had high impact. The high-impact group was more frequently triggered by mental health issues (50% vs 32%, p=0.016) and exercise (14% vs 4%, p=0.040), while the low-impact group was more often triggered by allergies (6% vs 1%, p=0.054) and coffee (11% vs 3%, 0.005). High-impact individuals had higher rates of comorbidities including pelvic floor dysfunction (39% vs 19%, 0.005), irritable bowel syndrome (36% vs 21%, p=0.029), overactive bladder (30% vs 17%, p=0.051), and/or vulvodynia (23% vs 9%, p=0.026).</p><p><strong>Conclusions: </strong>IC/BPS encompasses a spectrum of disease manifestations. While demographics remain relatively uniform in this IC/BPS population, symptom patterns, comorbidities, and therapeutic choices are correlated with impact on quality of life.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620745","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":"Outcomes for Stress Incontinence Procedures for Men and Women With Neurogenic Lower Urinary Tract Dysfunction: A Multicenter Neurogenic Bladder Research Group Study.","authors":"Javier E Santiago, Min Soo Choo, Richard Mora, Evgeniy Kreydin, David A Ginsberg, Natalia Hernandez, Paola Bustillos, Rose Khavari, Renee M Cole, Stephanie Daignault-Newton, John T Stoffel","doi":"10.1016/j.urology.2025.06.068","DOIUrl":"10.1016/j.urology.2025.06.068","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and durability of procedures to treat stress urinary incontinence (SUI) in male and female patients with neurogenic lower urinary tract dysfunction.</p><p><strong>Methods: </strong>A retrospective multi-institutional review by the Neurogenic Bladder Research Group of male and female patients with neurogenic lower urinary tract dysfunction who underwent urethral bulking injection (UBI), sling placement, or artificial urinary sphincter (AUS) for SUI between 2012 and 2020 was performed. The primary outcome was time to procedural failure, defined as return to baseline preoperative SUI symptoms and/or needing additional procedures for SUI. Men and women were analyzed separately, and univariate and multivariable models were constructed.</p><p><strong>Results: </strong>Forty-five males and 35 females were included. The majority had a diagnosis of spina bifida (men-60%, female-28%) or spinal cord injury (men-15%, female-5%). Median age for males was 33 years with median post-operative follow-up of 627 days. Six-month failure rates and median time to failure were: UBI-53% and 5.3 months; sling-21% and 42 months; AUS-21%. Median age for females was 44 years with median post-operative follow-up of 363 days. Six-month failure rates and median time to failure were: UBI-68% and 2.6 months; sling-50% and 7.3 months. Prior bladder reconstruction and spinal cord injury were associated with failure in males; prior urethral surgery was associated with failure in females.</p><p><strong>Conclusion: </strong>SUI surgery outcomes differ between males and females with shorter failure-free survival with UBI compared to AUS and sling in males, while UBI and sling placement both demonstrated short failure-free survival in females.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620746","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 Effect of Video Use on the Anxiety Levels of Parents of Children Undergoing Orchiopexy: A Prospective Randomized Controlled Study.","authors":"Mehmet Cetin, Cagri Akin Sekerci, Turker Altuntas, Onur Can Ozkan, Yiloren Tanidir, Selcuk Yucel, Tufan Tarcan, Kamil Cam","doi":"10.1016/j.urology.2025.07.003","DOIUrl":"10.1016/j.urology.2025.07.003","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect that an educational animated video has on the anxiety and depression levels of parents with children undergoing orchiopexy, a commonly performed surgery in pediatric urology, this study builds on previous findings that preoperative multimedia tools can effectively reduce parental anxiety.</p><p><strong>Methods: </strong>Parents of children scheduled for orchiopexy between 15/12/2023 and 15/10/2024 were enrolled. Exclusion criteria included prior urological surgery or additional procedures. Children were randomized into two groups. Group 1 received the standard informed consent form and verbal information three days preoperatively, while group 2 additionally watched a 6-minute educational video. Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI), and State-Trait Anxiety Inventory (STAI) scores were obtained preoperatively and 1 week postoperatively.</p><p><strong>Results: </strong>Seventy-four children with a median age of 5.5 (1-13) years were randomized into two groups (37 per group). Mothers were primary caregivers in 74.3% of cases. Anxiety and depression scores significantly decreased postoperatively in both groups, except for STAI-II. Group 2 had significantly lower preoperative HADS-T (11-6), BAI (3-1), and STAI-I (41-35) scores and lower postoperative HADS-D (4.5-2) and STAI-I (36.5-26.5) scores (P = .029, P = .008, P = .007, P = .041, P = .043, respectively). Bilateral cases had higher anxiety and depression scores (P = .019). Multimedia use was more effective in parents with higher education (P = .001).</p><p><strong>Conclusion: </strong>This prospective randomized trial is the first to demonstrate that preoperative multimedia video education significantly reduces anxiety and depression levels in parents of children undergoing orchiopexy.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576364","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":"Fertility Preservation in Pediatric Cancer Patients.","authors":"Megan A Stout, Jessica H Hannick, Lauren E Corona","doi":"10.1016/j.urology.2025.07.002","DOIUrl":"10.1016/j.urology.2025.07.002","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576363","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":"Antibiotic Prophylaxis Before Urodynamics: A Urine Culture-Based Versus Risk-Factors-Based Protocol to Minimize Usage in the Era of Antibiotic Resistance.","authors":"Omri Schwarztuch Gildor, Elad Yosef, Netanel Levin, Anna Itshak, Rony Vainrib, Michael Vainrib","doi":"10.1016/j.urology.2025.07.001","DOIUrl":"10.1016/j.urology.2025.07.001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical effectiveness of a culture-based antibiotic prophylaxis (AP) protocol before urodynamic studies (UDS), and to compare antibiotic use and infection rates against recommendations from the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Best Practice Policy Statement (BPPS).</p><p><strong>Methods: </strong>A retrospective cohort study of 1666 adult patients who underwent UDS. All patients were managed under a local protocol requiring a urine culture (UC) prior to UDS. Patients with positive UC received an oral antibiotic course, which was initiated 72 hours prior to the study. Post-UDS UTI was defined as a symptomatic infection confirmed by positive UC.</p><p><strong>Results: </strong>Three hundred fifty-two (21.1%) patients with positive UC, treated with AP. Among the remaining 1314 (78.9%) patients with negative UC, 62% had SUFU-defined risk factors but did not receive AP. The overall post-procedural UTI rate was 1.9% in the no-AP group and 1.7% in patients with positive UC who received AP (P = .807). No statistically significant difference in UTI rates was found between \"index\" and \"non-index\" patients (0.7% vs 1.8%, P = .126). Applying SUFU BPPS would have required AP in 83.4% of patients, while our approach reduced this by more than 60%.</p><p><strong>Conclusion: </strong>A UC-guided approach minimizes unnecessary antibiotic exposure without compromising patient safety. We support the integration of culture-based decision-making in urodynamic practice, especially in the context of rising antimicrobial resistance.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576362","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":"A 74-Year-Old Man With Ureteral Wall Thickening and Hydronephrosis: Malignancy or Mimicker?","authors":"Yen Ho, Kao-Lang Liu, Wei-Che Wu, Yih-Leong Chang, Chen-Tu Wu, Yu-Chuan Lu","doi":"10.1016/j.urology.2025.06.066","DOIUrl":"10.1016/j.urology.2025.06.066","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567893","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":"Applicant Preferences and Perspectives in the New Era of the Urology Residency Match.","authors":"Trevor C Hunt, Benedikt M Winzer, George K Siodis, Jean-Pierre Trey Kanumuambidi, Scott O Quarrier, Hani H Rashid","doi":"10.1016/j.urology.2025.06.069","DOIUrl":"10.1016/j.urology.2025.06.069","url":null,"abstract":"<p><strong>Objective: </strong>To assess urology residency applicants' preferences and perspectives regarding key issues in a new urology match era that includes both in-person and virtual interviews.</p><p><strong>Methods: </strong>Applicants to our residency program from the 2024 to 2025 American Urological Association match cycle were surveyed. Issues assessed included interview format preferences, costs, ability to judge \"fit\" with programs, and decisions made throughout the application cycle. When applicable, items were grouped by time point as pre-interview, day of interview, or post-interview.</p><p><strong>Results: </strong>The response rate was 45% (75/166). Applicants attended 13 interviews on average, 7 in person and 6 virtual. Only 10% of invitations included a hybrid option, and just 9% offered any financial aid. Applicants strongly preferred in-person interviews (49.3%) or hybrid formats (40.0%) compared to virtual (10.7%). For judging fit, an even larger majority preferred in-person (76.0%) over virtual (4.0%), especially on the interview day itself. Applicants spent $4994 total (applications: $1913, interviews: $3081), averaging $410 per in-person interview. Nearly all applicants felt the costs and travel time of in-person interviewing were worth it (91% and 95%, respectively). However, 19% of applicants had to decline one or more in-person interviews due to costs.</p><p><strong>Conclusion: </strong>Urology applicants now largely favor in-person interviews over virtual, especially when judging \"fit,\" and believe they are worth the increased costs and logistical challenges. However, financial constraints limited access to interview opportunities for a substantial cohort. Future innovations in the urology match may explore broader implementation of hybrid interview formats as issues of applicant preferences and equity are balanced.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561303","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":"Utilization, Acute Complications, and Delays in Treatment Associated With Rectal Spacers for Prostate Cancer Radiotherapy.","authors":"Jack C Millot, Adithya Balasubramanian, Lauren Chew, Gal Wald, Camilo Arenas-Gallo, Edward Zhang, Jacob McCann, Leo D Dreyfuss, Stephen Rhodes, Patrick Lewicki, Angela Y Jia, Nicholas G Zaorsky, Jonathan E Shoag","doi":"10.1016/j.urology.2025.06.070","DOIUrl":"10.1016/j.urology.2025.06.070","url":null,"abstract":"<p><strong>Objective: </strong>To investigate rectal hydrogel spacer use, placement complications, and associated radiation delays in the United States.</p><p><strong>Methods: </strong>The Merative MarketScan Database was used to identify prostate cancer patients undergoing spacer placement or radiation alone between 2016 and 2021. Genitourinary and gastrointestinal complications and subsequent interventions that occurred after spacer placement but before radiation were captured. A 6-month window preceding spacer placement was employed to eliminate underlying diagnoses present before spacer placement. Delays in starting radiation after spacer placement were identified and categorized as more than 1, 2, or 3 months. A Cox proportional hazards model with a time-varying covariate of acute complications was used to assess the effect of complications on time-to-radiation.</p><p><strong>Results: </strong>We captured 3,732 spacer placements, of which 3,650 (97.8%) underwent radiation. The use of spacers among prostate cancer radiation patients increased from 0.5% in 2016 to 25.7% in 2021. Stereotactic body radiotherapy (SBRT) patients had the highest spacer use at 50.0% in 2021. Complications occurred in 6.4% (n = 235) of patients before starting radiation. Of these, 5.2% (n = 190) were genitourinary and 1.2% (n = 43) were gastrointestinal complications. Catheterization, cystoscopy, rectal endoscopy, and rectal abscess drainage were required for 21 (0.6%), 15 (0.4%), 12 (0.3%), 1 (0.03%), and 1 (0.03%) patients, respectively. Following a complication, patients had a significantly lower risk (Hazard Ratio 0.75, 95% CI 0.66-0.86, P <.001) of starting radiation compared to before the complication.</p><p><strong>Conclusion: </strong>Rectal spacer use is prevalent amongst patients undergoing SBRT. While rare, spacer placement complications occur, which can delay the start of radiation therapy.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561305","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":"Revisiting the Role of Lymphovascular Invasion in Prostate Cancer: A Narrative Review.","authors":"Jakub Karwacki, Laura Wojdyło, Karolina Klasen, Andrzej Dłubak, Adam Gurwin, Maciej Kaczorowski, Agnieszka Hałoń, Wojciech Krajewski, Tomasz Szydełko, Bartosz Małkiewicz","doi":"10.1016/j.urology.2025.06.063","DOIUrl":"10.1016/j.urology.2025.06.063","url":null,"abstract":"<p><p>Lymphovascular invasion (LVI) is an adverse histopathological marker in prostate cancer, associated with increased risks of disease progression and biochemical recurrence. Despite its established value as an independent predictive factor, LVI remains underutilized in clinical decision-making. In particular, LVI identified in radical prostatectomy specimens does not currently influence management strategies, even though numerous studies highlight its critical role in patient outcomes. This review synthesizes recent literature on the clinical significance of LVI in prostate cancer, emphasizing its relationship with biochemical recurrence, lymph node invasion, and survival parameters. Future directions highlight the need for larger prospective studies, standardized definitions, and AI-driven histopathological tools to enhance the detection and integration of LVI into clinical practice.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561304","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 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":"Muhammed A M Hammad, Mark I Sultan, Ramy F Youssef","doi":"10.1016/j.urology.2025.06.059","DOIUrl":"10.1016/j.urology.2025.06.059","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555071","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}