IF 2.1 3区医学

Urology Pub Date : 2025-06-07 DOI: 10.1016/j.urology.2025.06.004

Chad W M Ritenour, Evan Thoman, Nicholas W Eyrich

引用次数: 0

Feasibility and Outcomes After Robot-Assisted Sigmoid Vaginoplasty for Gender Dysphoria. 机器人辅助乙状结肠阴道成形术治疗性别焦虑症的可行性和结果。

IF 2.1 3区医学

Urology Pub Date : 2025-06-07 DOI: 10.1016/j.urology.2025.06.003

Michaela Sljivich, Camille Torres, Derek Chen, Tatyana Yatsenko, Peter Wiklund, Miroslav Djordjevic, Rajveer S Purohit

{"title":"Feasibility and Outcomes After Robot-Assisted Sigmoid Vaginoplasty for Gender Dysphoria.","authors":"Michaela Sljivich, Camille Torres, Derek Chen, Tatyana Yatsenko, Peter Wiklund, Miroslav Djordjevic, Rajveer S Purohit","doi":"10.1016/j.urology.2025.06.003","DOIUrl":"10.1016/j.urology.2025.06.003","url":null,"abstract":"Objective: To present our technique of robot assisted sigmoid vaginoplasty (RSV) for both primary and in revision cases of vaginoplasty.Methods: Patients were retrospectively evaluated between 2020 and 2024 who underwent either primary or revision RSV. The technique for the surgery is described. Demographics, complications, vaginal depth (VD), and hospital events were analyzed after chart review.Results: Thirty-six patients underwent robotic-assisted sigmoid vaginoplasty. Eleven underwent primary RSV and 25 underwent revision vaginoplasty for vaginal stenosis (25) and prostato-vaginal fistula (4). Mean age was 36.1 years, operative time was 272.9 mins, mean length of stay was 3.7 days. Mean VD was 17.6 cm (3.7 SD). In patients who underwent revision vaginoplasty for stenosis, preoperative VD was on average 3.4 cm (3.3 SD) and none developed fistulas. 2 developed a sigmoid-skin anastomotic vaginal stricture requiring intervention. Most patients expressed satisfaction with their surgery and outcomes. None reported a change in bowel habits, vaginitis, or excessive discharge that persisted after 3 months post-op, and none had evidence of diversion neo-vaginal colitis on post-operative vaginoscopy.Conclusion: RSV is a feasible and safe technique as a primary option for vaginoplasty or as a revision to treat vaginal stenosis. Larger and longer comparative studies are needed to assess the utility and long-term functional outcomes of this technique.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258945","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

Optimizing Pediatric Genital Reconstruction: The Role of Z-Plasty in Enhancing Aesthetic and Functional Outcomes. 优化儿童生殖器重建：z形成形术在提高美学和功能结果中的作用。

IF 2.1 3区医学

Urology Pub Date : 2025-06-07 DOI: 10.1016/j.urology.2025.06.011

Diego R Álvarez Vega, Jordan L Mendelson, Jordan S Gitlin, Parth Joshi, Moneer K Hanna

{"title":"Optimizing Pediatric Genital Reconstruction: The Role of Z-Plasty in Enhancing Aesthetic and Functional Outcomes.","authors":"Diego R Álvarez Vega, Jordan L Mendelson, Jordan S Gitlin, Parth Joshi, Moneer K Hanna","doi":"10.1016/j.urology.2025.06.011","DOIUrl":"10.1016/j.urology.2025.06.011","url":null,"abstract":"Objective: To assess the effectiveness, technical considerations, and long-term outcomes of the Z-plasty technique for correcting pediatric penile and scrotal anomalies.Methods: A retrospective analysis of 100 consecutive Z-plasty procedures across various pediatric urological conditions was conducted. These included bifid scrotum reconstruction, chordee correction, penoscrotal webbing repair, and complex hypospadias reconstruction. Technical variations, including classic Z-plasty, multiple Z-plasties, and double-opposing Z-plasty configurations were evaluated. Patients were followed for a minimum of one year (range: 1-2 years), with 97% completing all scheduled follow up visits.Results: Z-plasty successfully addressed a spectrum of penile and scrotal abnormalities including 41 hypospadias revisions, 28 primary hypospadias repairs, 10 chordee corrections, and 21 other reconstructive procedures, through strategic modification of the number and angles of incisions. Primary skin flap healing was achieved in 98% of procedures. Only one case (1%) required healing by secondary intention due to suture line separation, and one (1%) developed a hypertrophic scar managed with local steroid application. All patients with complete follow-up (97%) demonstrated stable corrections with minimal visible scarring at final evaluation.Conclusion: Z-plasty is a highly effective, versatile, and safe technique for pediatric genital reconstructive surgery. This adaptable approach enables optimal resurfacing and correction of diverse penoscrotal abnormalities with minimal morbidity. By minimizing linear scarring and redistributing tissue tension, Z-plasty simultaneously improves cosmetic outcomes and provides durable functional benefits. Future studies should focus on establishing standardized outcome measures and evaluating long-term results into adulthood.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258955","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 "Safety of Partial and Radical Nephrectomy for Complex Locally Advanced Renal Cell Carcinoma After Neo-Adjuvant Immune Checkpoint Inhibition-Analysis From a Phase 1b Trial (Durvalumab +/- Tremelimumab)". 编辑评论“新辅助免疫检查点抑制后部分和根治性肾切除术治疗复杂的局部晚期肾细胞癌的安全性——来自1b期试验（Durvalumab +/- Tremelimumab）的分析”。

IF 2.1 3区医学

Urology Pub Date : 2025-06-06 DOI: 10.1016/j.urology.2025.05.071

Matthew S Lee, Abhinav Khanna

引用次数: 0

Reply to Letter to the Editor on "Long-term Outcomes of Conservative Management for Lichen Sclerosus Urethral Stricture Disease". 对“硬苔性尿道狭窄疾病保守治疗的长期结果”致编辑的回复。

IF 2.1 3区医学

Urology Pub Date : 2025-06-06 DOI: 10.1016/j.urology.2025.05.072

Anna J Saltman, Alex J Vanni

引用次数: 0

Letter to the Editor on "The Statistical Fragility of Randomized Controlled Trials in Kidney Stone Management: An Analysis of AUA and EAU Guidelines". 致编辑的信“肾结石管理随机对照试验的统计脆弱性：AUA和EAU指南的分析”。

IF 2.1 3区医学

Urology Pub Date : 2025-06-04 DOI: 10.1016/j.urology.2025.05.073

Zhihao Lei

引用次数: 0

Editorial Comment on "Effect of Age on Robotic-Assisted Radical Prostatectomy Outcomes: A Multi-center Analysis". 特邀评论“年龄对机器人辅助根治性前列腺切除术结果的影响：一项多中心分析”。

IF 2.1 3区医学

Urology Pub Date : 2025-06-03 DOI: 10.1016/j.urology.2025.05.061

Abhilash Moolupuri, John M Lacy

引用次数: 0

Reply to Editorial Comment on "A Predictive Model for the Risk of Procedural Failure in Retrograde Ureteral Stenting for Malignant Extrinsic Ureteral Obstruction". 作者对“恶性输尿管梗阻逆行输尿管支架置入失败风险的预测模型”社论评论的回应。

IF 2.1 3区医学

Urology Pub Date : 2025-06-03 DOI: 10.1016/j.urology.2025.05.065

Shuhan Liu, Zongyao Hao

引用次数: 0

Trends in Urology Resident Surgical Autonomy: What Do ACGME Chief Resident Case Logs Indicate? 泌尿外科住院医师手术自主性的趋势：ACGME总住院医师病例记录表明了什么？

IF 2.1 3区医学

Urology Pub Date : 2025-06-03 DOI: 10.1016/j.urology.2025.05.070

Niccola B Lynch, Jonah Samuel, Zachary Corey, Prakash Gorroochurn, Gary E Lemack, Adam P Klausner, Akanksha Mehta, Mathew D Sorensen, Ryan Smith, Jill C Buckley, R Houston Thompson, Benjamin N Breyer, Eric M Wallen, Jay D Raman, Gregory A Joice, Gina M Badalato

{"title":"Trends in Urology Resident Surgical Autonomy: What Do ACGME Chief Resident Case Logs Indicate?","authors":"Niccola B Lynch, Jonah Samuel, Zachary Corey, Prakash Gorroochurn, Gary E Lemack, Adam P Klausner, Akanksha Mehta, Mathew D Sorensen, Ryan Smith, Jill C Buckley, R Houston Thompson, Benjamin N Breyer, Eric M Wallen, Jay D Raman, Gregory A Joice, Gina M Badalato","doi":"10.1016/j.urology.2025.05.070","DOIUrl":"10.1016/j.urology.2025.05.070","url":null,"abstract":"Objective: To investigate urology resident surgical autonomy trends over time and according to procedure subtype using Accreditation Council for Graduate Medical Education (ACGME) case log data.Methods: A retrospective review of 364 chief urology resident ACGME case logs collected from 11 institutions spanning 2010-2021 was completed. Resident-defined role in cases as \"assistant,\" \"surgeon,\" or \"teaching surgeon\" were used as a metric of graded autonomy. An autonomy score was calculated. Analysis of variance (ANOVA) evaluated differences in autonomy between institutions, within institutions, and between procedure types. Generalized estimating equations assessed changes in autonomy over time.Results: Mean autonomy scores were significantly different between procedure categories, with general urology/endourology having the highest autonomy, reconstruction/pediatrics having the second highest autonomy, and oncology having the lowest autonomy (P <.05 across all comparators). Between institution variance in autonomy was significantly greater than within institution variance (0.09396 vs 0.01109, P <.0001). Globally, mean autonomy scores significantly decreased from 2010 to 2021 by a value of 0.007 per year (P <.001).Conclusion: Surgical autonomy, as extrapolated from self-reported urology chief resident ACGME case logs, varied according to procedure type, with general urology and endourology ranking highest and oncology ranking lowest. Overall, chief resident autonomy scores decreased significantly over time. If validated in a larger national cohort, these findings may have implications for contemporary urologic training in terms of resident confidence and self-sufficiency for independent practice.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235361","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 "The Statistical Fragility of Randomized Controlled Trials in Kidney Stone Management: An Analysis of AUA and EAU Guidelines". 编辑评论回复：肾结石管理随机对照试验的统计脆弱性：对AUA和EAU指南的分析。

IF 2.1 3区医学

Urology Pub Date : 2025-06-03 DOI: 10.1016/j.urology.2025.05.066

David F Friedlander

引用次数: 0

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