Urology最新文献

{"title":"Clinical Predictors of Micro-Testicular Sperm Extraction Success in Nonobstructive Azoospermia With Complete Azoospermia Factor c Microdeletion","authors":"Mustafa Emre Bakircioglu ,&nbsp;Kadir Can Sahin ,&nbsp;Cenk Ozcan ,&nbsp;Mehmet Hamza Gultekin ,&nbsp;Hamdi Ozkara","doi":"10.1016/j.urology.2025.01.066","DOIUrl":"10.1016/j.urology.2025.01.066","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical and histopathological parameters of sperm retrieval success using micro-testicular sperm extraction (micro-TESE) in nonobstructive azoospermia (NOA) with complete azoospermia factor c (AZFc) microdeletion, since there is limited data in the literature on the outcomes of this patient group and controversial results on the parameters affecting the success of micro-TESE in NOA patients.</div></div><div><h3>Methods</h3><div>The data of 1308 patients with NOA who underwent micro-TESE surgery at two centers between 2014 and 2022 were retrospectively analyzed. Clinical and histopathological data were comparatively assessed in men with complete AZFc microdeletion according to sperm retrieval success.</div></div><div><h3>Results</h3><div>Among the 1308 men, 54 (4.1%) were diagnosed with complete AZFc microdeletion. Micro-TESE was successful in retrieving sperm from 28 men with AZFc microdeletion (51.8%). The patient age, follicle-stimulating hormone and total testosterone levels, duration of infertility, and testicular volume did not statistically significantly differ between the sperm-positive and -negative groups (<em>P</em> <!-->&gt;.05). The analysis revealed that parental consanguinity was significantly different between the two groups (<em>P</em> <!-->=<!--> <!-->.032). According to the testicular biopsy results in terms of sperm retrieval status, no statistically significant difference was observed in the distribution of histopathological patterns.</div></div><div><h3>Conclusion</h3><div>Parental consanguinity was found to be the only parameter that negatively affected the success of micro-TESE in patients with NOA who presented with AZFc microdeletion. Clinical parameters, including patient age, follicle-stimulating hormone and total testosterone levels, and testis volume, did not demonstrate predictive value for sperm retrieval success in micro-TESE in this patient population.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 49-54"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374836","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 “Urological Outcomes and Adverse Events Following Total Pelvic Exenteration for Locally Advanced and Recurrent Rectal Cancer: A Single-center Retrospective Study”","authors":"Kevin J. Hebert","doi":"10.1016/j.urology.2025.01.036","DOIUrl":"10.1016/j.urology.2025.01.036","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 167-168"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047984","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 “Martius Labial Fat Pad Use in the Treatment of Complications Associated With Prior Surgery for Urinary Incontinence or Pelvic Organ Prolapse”","authors":"Kemal Demirhan","doi":"10.1016/j.urology.2025.01.015","DOIUrl":"10.1016/j.urology.2025.01.015","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Page 243"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972260","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":"Impact of Planned Research Gap Year on Urology Residency Match Success","authors":"Minhaj Jabeer,&nbsp;Amandip Cheema,&nbsp;Athena Barrett,&nbsp;Adithya Chandrasekaran,&nbsp;Meredith Meyer,&nbsp;Christine Van Horn,&nbsp;John P. Richgels,&nbsp;Ahmad M. El-Arabi,&nbsp;Jeffrey L. Ellis,&nbsp;Kristin G. Baldea","doi":"10.1016/j.urology.2025.01.030","DOIUrl":"10.1016/j.urology.2025.01.030","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the impact of a planned research gap year (RGY) on match outcomes and research productivity among urology residency applicants in the context of the highly competitive urology specialty and the new pass/fail format for the United States Medical Licensing Exam (USMLE) Step 1 exam.</div></div><div><h3>Methods</h3><div>We conducted an Institutional Review Board-approved analysis of applicants to our program during the 2022-2023 and 2023-2024 application cycles. Data on demographics, medical school rank, having a home urology program, USMLE Step 1 scores, and Electronic Residency Application Service (ERAS) research entries were collected. Match outcomes were verified via the Society of Academic Urologists listing. Statistical analyses were performed to compare characteristics and outcomes between the two cohorts.</div></div><div><h3>Results</h3><div>Out of 560 total applicants, 61 (10.9%) pursued a RGY. RGY applicants were older (28.2 vs 26.9 years, <em>P</em> &lt;.001), attended higher-ranked medical schools (medical school rank 28 vs 56, <em>P</em> = .028), with lower USMLE Step 1 scores (237 vs 244, <em>P</em> = .004). RGY applicants demonstrated higher research productivity, with a median of 26 ERAS research entries compared to 12 in non-RGY applicants (<em>P</em> &lt;.001). Match rates were comparable (88.5% vs 85.3%, <em>P</em> = .496). RGY utilization was similar between allopathic and osteopathic applicants.</div></div><div><h3>Conclusion</h3><div>A planned RGY produced more research but did not culminate in higher match rates. The opportunity to take an RGY was equally accessible to both MD and DO applicants. While an RGY may enhance research output, we did not observe an increased match rate among those who utilized it.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 236-240"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029815","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 “Martius Labial Fat Pad Use in the Treatment of Complications Associated With Prior Surgery for Urinary Incontinence or Pelvic Organ Prolapse”","authors":"Sonia Guérin ,&nbsp;Maude Carmel ,&nbsp;Gary Lemack ,&nbsp;Zine-Eddine Khene ,&nbsp;Philippe Zimmern","doi":"10.1016/j.urology.2025.01.048","DOIUrl":"10.1016/j.urology.2025.01.048","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 244-245"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075781","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 “Clinical Predictors of Micro-Testicular Sperm Extraction Success in Nonobstructive Azoospermia With Complete Azoospermia Factor c Microdeletion”","authors":"Nicholas A. Deebel ,&nbsp;Robert E. Brannigan","doi":"10.1016/j.urology.2025.02.005","DOIUrl":"10.1016/j.urology.2025.02.005","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 55-56"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415292","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":"Contrast-enhanced Ultrasound Imaging Following Transperineal Laser Ablation for Lower Urinary Tract Symptoms","authors":"R.A.A. van Kollenburg ,&nbsp;L.A.M.J.G. van Riel ,&nbsp;J.R. Oddens ,&nbsp;T.M. de Reijke ,&nbsp;T.G. van Leeuwen ,&nbsp;D.M. de Bruin","doi":"10.1016/j.urology.2024.11.043","DOIUrl":"10.1016/j.urology.2024.11.043","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the shape and volume of ablations created by transperineal laser ablation (TPLA) using multiple fiber configurations. Furthermore, to measure the change in the ablation zone and prostate volume over time, and to assess inter-patient ablation volume variability.</div></div><div><h3>Methods</h3><div>Data from a prospective, single-center, interventional pilot study including 20 patients is used. All subjects underwent TPLA using the EchoLaser system, using 2 to 4 fibers, depending on prostate size and shape. Contrast-enhanced ultrasound (CEUS) was performed post-treatment and at 1 and 12 months. The prostate and ablation zone volumes were calculated on segmented CEUS imaging.</div></div><div><h3>Results</h3><div>The ablation zones were clearly identified on CEUS as non-perfused areas. Depending on fiber configuration, their shape varied from an ellipsoid to a clover profile. Ablation volumes varied from 0.9 (0.6-2.2)<!--> <!-->cm³ using a single fiber and 1800 J to 8.7 (3.9-19.0)<!--> <!-->cm³ (median, range) using 2 fibers and 7200 J energy per lobe at 1 month. At 12 months, the majority of the ablation zones showed a volume reduction. Median prostate volume decreased from 78 (37-145)<!--> <!-->cm³ at baseline to 46 (27-124)<!--> <!-->cm³ at 12 months (<em>P<!--> </em>=<!--> <!-->.0002). There was a relation between prostate volume reduction and Qmax (slope<!--> <!-->=<!--> <!-->0.18) and IPSS (slope<!--> <!-->=<!--> <!-->−0.18) improvement.</div></div><div><h3>Conclusion</h3><div>This study described ablation zone shape and measured the ablation volume following TPLA by various fiber configurations using CEUS, and compared these to functional outcomes. Prostate volume reduced significantly during follow-up. Segmentation showed substantial inter-patient ablation volume variation, which limits treatment predictability and thus accuracy.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 141-147"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740705","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":"Transitional Outcomes of Adults Who Underwent Cohen Ureteroneocystostomy for the Treatment of Vesicoureteral Reflux as Children","authors":"Tayfun Oktar ,&nbsp;Ismail Selvi ,&nbsp;M. İrfan Dönmez ,&nbsp;Mehmet Gürcan ,&nbsp;Arda Tunç Aydınoğlu ,&nbsp;Orhan Ziylan","doi":"10.1016/j.urology.2024.12.006","DOIUrl":"10.1016/j.urology.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the transitional outcomes of children who underwent Cohen ureteroneocystostomy(UNC) due to vesicoureteral reflux(VUR).</div></div><div><h3>Methods</h3><div>Files of patients who underwent UNC between January 2003 and December 2013 and had &gt;10 years of follow-up were retrospectively reviewed. Demographic and clinical data before surgery were noted. Lower urinary tract dysfunction (LUTD) status was assessed via ICIQ M/F-LUTS, voiding diary and uroflowmetry in all patients. Renal functions, hypertension, proteinuria, febrile/afebrile urinary tract infections(UTIs), and complications associated with pregnancy were noted.</div></div><div><h3>Results</h3><div>Two hundred and forty-one patients (140 girls, 58.1%) underwent UNC at a median age of 6.5 years (3-14), and 57.7% underwent bilateral surgery. After a median follow-up of 15 years (10-20), median patient age at the last clinic visit was 21 years (18-31). LUTD was detected in 69 (28.6%) patients. Bilateral disease, female gender, history of childhood bladder bowel dysfunction(BBD), presence of renal scar, and older age (≥7 years) at the time of surgery were significantly associated with LUTD in adulthood. Febrile UTI was detected in 7.9% (19/241) following UNC, whereas 6 needed subureteral injection due to persistent low-grade VUR. No patient developed stage 3 or greater chronic kidney disease, but 11(4.6%) patients developed hypertension and 7(2.9%) had proteinuria. Of 67 sexually active female patients,10(14.9%) had febrile UTIs. Of 49 women in whom pregnancy was observed,4(8.1%) had febrile UTIs, 7(14.2%) had afebrile UTIs and 2(4.1%) had pre-eclampsia during pregnancy, but none had a miscarriage or early labor.</div></div><div><h3>Conclusion</h3><div>Despite VUR control, the incidence of febrile UTI and pre-eclampsia during pregnancy should not be underestimated. In addition, a quarter of patients face LUTD when they reach adulthood. Female patients with bilateral disease, renal scar, and previous childhood BBD have higher risks for these transitional clinical problems.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 106-114"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822752","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 “Urological Outcomes and Adverse Events Following Total Pelvic Exenteration for Locally Advanced and Recurrent Rectal Cancer: A Single-center Retrospective Study”","authors":"Arun Sahai ,&nbsp;Nikki Kerdegari ,&nbsp;Alexis Schizas","doi":"10.1016/j.urology.2025.02.011","DOIUrl":"10.1016/j.urology.2025.02.011","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Page 169"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459748","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 “Clinical Predictors of Micro-Testicular Sperm Extraction Success in Nonobstructive Azoospermia With Complete Azoospermia Factor c Microdeletion”","authors":"M. Emre Bakircioglu ,&nbsp;Kadir Can Sahin ,&nbsp;Cenk Ozcan ,&nbsp;Mehmet Hamza Gultekin ,&nbsp;Hamdi Ozkara","doi":"10.1016/j.urology.2025.02.013","DOIUrl":"10.1016/j.urology.2025.02.013","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Page 57"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469295","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}