Urology最新文献

{"title":"Economic Burden of Urinary Incontinence in Men With Prostate Cancer: Results From the Medical Expenditure Panel Survey (2016-2021).","authors":"Jennifer Slota, Aurash Naser-Tavakolian, Emily Ji, Conor Driscoll, Rebecca Arteaga, Devin Boehm, Jonathan Rosenfeld, Aidan Raikar, Jaewoo Kim, Channa Amarasekera, Ziho Lee","doi":"10.1016/j.urology.2025.09.014","DOIUrl":"10.1016/j.urology.2025.09.014","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the economic burden of urinary incontinence among prostate cancer survivors using nationally representative data, focusing on differences in healthcare expenditures and utilization between survivors with and without incontinence.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using 2016-2021 data from the Medicare Expenditure Panel Survey. Men with self-reported prostate cancer were categorized by incontinence status. The primary outcome was the likelihood of incurring above-average total healthcare expenditures. Secondary outcomes included expenditures by care setting and frequency of outpatient visits. Survey-weighted multivariable logistic regression models were utilized to analyze expenditures, adjusting for age, race, insurance status, and education level.</p><p><strong>Results: </strong>The final weighted study population represented 3,060,848 prostate cancer survivors (76,759 with incontinence and 2,984,089 without). Survivors with incontinence were more often uninsured (8.9% vs 1.1%; P=.004) and less likely to have private insurance (2.5% vs 14.7%; P=.004). After adjustment, incontinence was associated with higher odds of above-average total expenditures (adjusted odds ratio [aOR] 2.33; 95% confidence interval [CI] 1.18-4.60; P=.015), largely driven by outpatient visits (aOR 3.81; 1.76-2.76; P=.001), outpatient expenditures (aOR 2.46; 95% CI 1.10-5.50; P=.029) and other non-facility-related expenditures (aOR 2.43; 95% CI 1.17-5.08; P=.018). Survivors with incontinence averaged 9 outpatient visits annually versus 6 among those without incontinence (P=.015).</p><p><strong>Conclusion: </strong>Urinary incontinence significantly increases healthcare utilization and expenditures among prostate cancer survivors, particularly through outpatient care and incontinence-related medical supplies. Targeted strategies to prevent and manage incontinence may reduce long-term economic burden and improve survivorship care.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065838","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":"Uncovering the Rare: A Systematic Review and Patient-level Meta-analysis of Testicular Metastases From Renal Cell Carcinoma.","authors":"Naufal Naushad, Tarek Shendy, Tanveer Mahmood, Abdalla Deb, Hosam Serag, Abraham Vinod Peedikayil","doi":"10.1016/j.urology.2025.09.016","DOIUrl":"10.1016/j.urology.2025.09.016","url":null,"abstract":"<p><strong>Objective: </strong>To conduct the largest and most comprehensive individual patient data (IPD) meta-analysis to date on testicular metastases from renal cell carcinoma (RCC), with the aim of characterizing clinical features, quantifying survival outcomes, and identifying predictors of recurrence and mortality.</p><p><strong>Methods: </strong>A systematic review was performed in April 2025 using PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies included histologically confirmed testicular metastases from RCC with extractable patient-level data. Fifty-three cases from 40 articles were included. One unpublished case from our institution was included. We extracted demographics, pathology, treatment, imaging, and outcome data. Tumor volume was calculated from ultrasound dimensions using the ellipsoid formula. For bilateral metastases, the mean volume was used in regression analysis.</p><p><strong>Results: </strong>The median overall survival was 17 months (interquartile ranges [IQR], 7.4-26), and progression-free survival was 9 months (IQR, 6-18.5). Lymph node metastasis (odds ratio [OR] = 15.7, P = .019) and presence of metastases at RCC diagnosis (OR = 6.5, P = .034) were associated with mortality. Synchronous metastases (OR = 38.5, P = .002) and lung involvement (OR = 28.0, P = .004) were predictors of recurrence. Survival differed significantly across Fuhrman grades (P = .032) and T stages (P = .047). In Cox regression, metastasis at diagnosis predicted shorter overall survival, while lung and lymph node involvement were the strongest predictors of recurrence.</p><p><strong>Conclusion: </strong>This meta-analysis provides the first pooled survival estimates and prognostic modeling for testicular RCC metastases. Findings support the value of early detection and confirm the prognostic impact of synchronous disease and nodal spread. These results establish a foundation for clinical risk stratification and long-term surveillance strategies in affected patients.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065802","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 \"Hematuria Cancer Risk Score in combination with Oncuria-Detect for patients undergoing evaluation for hematuria\".","authors":"Armine K Smith","doi":"10.1016/j.urology.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.urology.2025.09.010","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058621","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 \"Postprocedural Urethral Strictures After Aquablation\".","authors":"Nishant Garg, Jill C Buckley","doi":"10.1016/j.urology.2025.09.011","DOIUrl":"10.1016/j.urology.2025.09.011","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058647","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":"Labial Adhesions Secondary to Congenital Adrenal Hyperplasia.","authors":"Weilin Yang, Qiang Yue, Biyue Hu","doi":"10.1016/j.urology.2025.09.001","DOIUrl":"10.1016/j.urology.2025.09.001","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058606","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 \"National Assessment of Urology Interest Groups: A Cross-Sectional Study Analyzing Current Practices and Challenges\".","authors":"Lola P Lozano, Joanna Orzel, Jace Leininger, Ryan L Steinberg, Chad R Tracy","doi":"10.1016/j.urology.2025.09.003","DOIUrl":"10.1016/j.urology.2025.09.003","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055581","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":"Urethral Duplication Mimicking an Interlabial Cyst in a Girl: A Diagnostic Challenge.","authors":"Luciana Lerendegui, Juanita Velasquez, Daniel Tennenbaum, Miguel Castellan","doi":"10.1016/j.urology.2025.09.009","DOIUrl":"10.1016/j.urology.2025.09.009","url":null,"abstract":"<p><p>Urethral duplication is a rare urogenital anomaly, especially in females. We present the case of a preterm female with various congenital anomalies, hydrocolpos, and a persistent interlabial cyst, later found to be secondary to urethral duplication. At age 2, cystoscopy and VCUG confirmed a duplicated urethral tract. Surgical resection of the accessory urethra and genitoplasty were performed successfully. Postoperative recovery was uneventful, with excellent cosmetic and functional outcomes at follow-up. This case highlights urethral duplication as a rare but possible differential diagnosis for interlabial cystic lesions in females, particularly when associated with fluctuating size and underlying urogenital anomalies.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055616","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 \"Antibiotic Prophylaxis Is Not Required Before MRI-Guided Transperineal Prostate Biopsy\".","authors":"S F Sanne Westerhout, S P Sybren Rynja, P J Pim van Leeuwen, M A Arjen Noordzij","doi":"10.1016/j.urology.2025.09.002","DOIUrl":"10.1016/j.urology.2025.09.002","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055543","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":"Postoperative Symptom Severity and Time Course After Bilateral Ureteroscopy With Stents: Results From the Study to Enhance Understanding of Stent-associated Symptoms.","authors":"Alana C Desai, Jonathan D Harper, Naim M Maalouf, Hing Hung Henry Lai, Charles D Scales, Hongqiu Yang, Gregory E Tasian, Rebecca D McCune, Hussein R Al-Khalidi, Ziya Kirkali, Hunter Wessells, Jodi A Antonelli","doi":"10.1016/j.urology.2025.08.057","DOIUrl":"10.1016/j.urology.2025.08.057","url":null,"abstract":"<p><strong>Objective: </strong>To assess and compare stent-associated symptoms after unilateral vs bilateral ureteroscopy with ureteral stent placement for stone treatment.</p><p><strong>Methods: </strong>Participants enrolled in the Study to Enhance Understanding of Stent-Associated Symptoms (STENTS), a multicenter, prospective, observational cohort study, completed validated questionnaires and patient-reported outcome measures to assess stent-associated symptoms postoperatively. Patient-Reported Outcomes Measurement Information System (PROMIS) tools were used to measure pain intensity and interference due to pain, while the Ureteral Stent Symptom Questionnaire (USSQ) and Lower Urinary Tract Dysfunction Research Network Symptom Index-10 (LURN SI-10) were used to measure urinary symptoms. These data were used to determine symptom intensity and course, comparing outcomes after bilateral vs unilateral ureteroscopy.</p><p><strong>Results: </strong>Of the 484 participants who enrolled in STENTS, 60 underwent a bilateral procedure. Patients in the bilateral group reported greater increases in pain intensity and pain interference beginning on POD 3 (P = .017 and .022, respectively), continuing through POD 7-9, with no difference in interference 30 days after stent removal, compared to the unilateral group. Urinary symptoms were worse following a bilateral compared to unilateral procedure at all time points, except for similar urinary symptoms 30 days following stent removal.</p><p><strong>Conclusion: </strong>Patients undergoing bilateral compared to unilateral ureteroscopy report higher pain intensity, pain interference and urinary symptoms. Although exploratory, this analysis provides the most informative description of the patient experience with bilateral stents to date and may be useful in counseling patients considering bilateral stone treatment and in managing expectations.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-Glucose Transport Protein 2 Inhibitor Use Is Not Associated With Increased Risk of Inflatable Penile Prosthesis Infections Among Diabetic Patients.","authors":"Eric Wahlstedt, Jessica Schardein, John Wahlstedt, Joshua J Horns, Vaibhavi Vichare, Rupam Das, Jim Hotaling, Kelli Gross","doi":"10.1016/j.urology.2025.09.008","DOIUrl":"10.1016/j.urology.2025.09.008","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether diabetic patients taking sodium-glucose transport protein 2 inhibitors (SGLT2i) are at increased risk of inflatable penile prosthesis (IPP) infections, given the association of SGLT2i with higher rates of urinary tract and genital infections, and to assess the frequency of IPP infections in this patient population.</p><p><strong>Materials and methods: </strong>We performed a retrospective review of all diabetic men who underwent IPP placement utilizing the IBM MarketScan insurance claims database between 2011-2021. Demographic data, including age, smoking status, and obesity, were obtained. An IPP infection was identified based on ICD-9/10 and CPT codes. Multivariable analyses were performed to assess the likelihood of IPP infections.</p><p><strong>Results: </strong>A total of 2838 patients were identified. The median age was 61 years (55-66 years), with 61.0% classified as obese and 18.9% identified as smokers. Among these patients, 883 (31.1%) were on an SGLT2i. At a median follow-up of 25 months (10-49 months), 82 (2.9%) patients developed an infection, including 28 (3.2%) patients on SGLT2i and 54 (2.8%) patients on other diabetes medications. SGLT2i use was associated with a nonsignificant increase in the hazard ratio (HR) for infection [1.26 (P = .39)], while obesity and smoking were associated with statistically significant HRs [2.02 (P = .02) and 2.20 (P < .01), respectively].</p><p><strong>Conclusion: </strong>SLGT2i likely does not have a large effect on rates of IPP infection and may be continued perioperatively. Smoking cessation and weight loss may decrease the risk of IPP infections in diabetic patients, and counseling on this should be considered.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040889","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}