Urology最新文献

{"title":"Editorial Comment on “Correlation of 17-OH Progesterone Changes With Semen Parameters and Pregnancy Outcomes in Hypogonadal and Eugonadal Patients After Varicocelectomy”","authors":"William T. Berg","doi":"10.1016/j.urology.2025.04.007","DOIUrl":"10.1016/j.urology.2025.04.007","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 87-88"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017366","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":"Practice Variation and Guideline Compliance in Urologic Imaging After Initial Urinary Tract Infection in Children","authors":"Hsin-Hsiao Scott Wang ,&nbsp;Anh-Dao Cheng ,&nbsp;Jiali Cai ,&nbsp;Tenny R. Zhang ,&nbsp;Grace Chi ,&nbsp;Danielle de Torres ,&nbsp;Carlos Estrada ,&nbsp;Caleb P. Nelson","doi":"10.1016/j.urology.2025.04.025","DOIUrl":"10.1016/j.urology.2025.04.025","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate practice pattern variability and drivers of imaging after febrile UTI (fUTI).</div></div><div><h3>Methods</h3><div>We performed a retrospective review of all children ≤6 years old presenting between 2012 and 2021 who presented in a variety of settings (outpatient, inpatient, emergency department [ED]) with diagnosis of first fUTI to a single freestanding children’s hospital. Patients were excluded if no documented fever, no documented positive urine culture, or history of congenital urinary anomalies. The primary outcome was compliance with American Academy of Pediatrics guidelines regarding genitourinary (GU) imaging after the first or second fUTI. Secondary outcomes were whether patients received GU imaging and the timing of voiding cystourethrogram (VCUG). Multivariate logistic regression was performed.</div></div><div><h3>Results</h3><div>Four hundred seventy-three patients met criteria with a median age of 11 months. Overall, adherence to American Academy of Pediatrics guidelines was 41%, with no significant increase in compliance over time. Sixty-four percent (306/473) underwent renal-bladder ultrasound (RBUS) after the first fUTI. Of those with abnormal RBUS, 57.1% (44/77) underwent VCUG. Six patients had a VCUG after initial fUTI but no RBUS. Of those with a second fUTI, 36.7% (18/49) underwent VCUG. Notably, 32% received no GU imaging. On multivariate analysis, compliance was associated with younger age (OR 0.98) and inpatient treatment (OR 2.97). The receipt of any imaging was associated with younger age (OR 0.98), female patients (OR 1.78), inpatient treatment (OR 4.98), and private insurance (OR 1.72).</div></div><div><h3>Conclusion</h3><div>Non-adherence to guidelines on imaging after febrile UTI remains high in the pediatric community, indicating significant potential for improvement.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 191-197"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030038","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 “Real-World Economic Burden and Healthcare Resource Utilization of Radical Cystectomy and Trimodal Therapy for Bladder Cancer in the United States”","authors":"Daniel D. Joyce","doi":"10.1016/j.urology.2025.04.002","DOIUrl":"10.1016/j.urology.2025.04.002","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 70-71"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048342","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":"Deep Learning Algorithms to Predict Differential Renal Function <40% in Unilateral Hydronephrosis Based on Key Parameters of Urinary Tract Ultrasound","authors":"Jiaxin Huang ,&nbsp;Liyuan Geng ,&nbsp;Yue Hu ,&nbsp;Zhoutong Chen ,&nbsp;Hongquan Geng ,&nbsp;Xingang Cui ,&nbsp;Xiaoliang Fang","doi":"10.1016/j.urology.2025.04.009","DOIUrl":"10.1016/j.urology.2025.04.009","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To identify the correlation between ultrasound findings and the incidence of differential renal function (DRF) &lt;40%, we conducted an analysis of the key parameters of urinary tract ultrasound in children with unilateral hydronephrosis. For children with unilateral hydronephrosis, DRF &lt;40% serves as a compelling indication for surgical intervention, and it can be assessed through diuretic renogram. However, a significant number of patients do not have convenient access to high-quality renograms. So we conducted this analysis aiming to identifying value of urinary tract ultrasound in surgical intervention decision.</div></div><div><h3>METHODS</h3><div>We retrospectively reviewed the dynamic renogram and urinary tract ultrasound data of 802 children with hydronephrosis presented to our department. Independent risk factors related to DRF &lt;40% were screened out. Several machine learning models were employed. The area under receiving operating curves (AUROC) was calculated for each model to compare their efficiency.</div></div><div><h3>RESULTS</h3><div>The renal pelvis anterior-posterior diameter, upper calyx dilation, and renal length ratio were found to be independent risk factors for DRF &lt;40%. Among these factors, the renal length ratio had the highest AUROC of 0.820. These 3 factors, alone with the patients’ age, were then introduced into 3 machine learning models: random forest, logistic regression, and support vector machines (SVM), among which, the SVM exhibited the highest AUROC of 0.941, with a sensitivity of 90.32% and a specificity of 81.03%.</div></div><div><h3>CONCLUSION</h3><div>The length ratio exhibited the strongest correlation with DRF &lt;40% among multiple ultrasound indices. Moreover, the SVM model exhibited significant improvement compared to individual factors. Therefore, it can be employed to identify high-risk children with impaired renal function in the assessment of congenital hydronephrosis.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 179-185"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050469","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":"Aims and Scope","authors":"","doi":"10.1016/S0090-4295(25)00455-8","DOIUrl":"10.1016/S0090-4295(25)00455-8","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Page A5"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242065","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":"Malignant Ectomesenchymoma in a 6-Month-Old: A Rare Pediatric Tumor Case Report","authors":"Juanita Velasquez Ospina ,&nbsp;Luciana Lerendegui ,&nbsp;Paulo Moscardi ,&nbsp;Daniel M. Tennenbaum ,&nbsp;Liset Pelaez ,&nbsp;Maggie E. Fader ,&nbsp;Matthew D. Ramirez ,&nbsp;Rafael Gosalbez","doi":"10.1016/j.urology.2025.01.056","DOIUrl":"10.1016/j.urology.2025.01.056","url":null,"abstract":"<div><div>Malignant ectomesenchymoma is a rare type of soft tissue tumor that contains both mesenchymal and neuroectodermal components. We present the case of a 6-month-old male with an abdomino-pelvic mass, initially diagnosed as embryonal rhabdomyosarcoma. He had poor response to chemotherapy and radiotherapy, and subsequent complete surgical resection demonstrated the tumor to be compatible with malignant ectomesenchymoma. This case highlights the diagnostic challenges, treatment complexity, and need for comprehensive histopathological evaluation in rare tumors. We aim to contribute to the limited literature and emphasize the importance of individualized, multimodal treatment approaches.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages e67-e71"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075780","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":"Simultaneous Bilateral Percutaneous Nephrolithotomy: Is It Cost-Effective?","authors":"Gillian Murray ,&nbsp;Austen Slade ,&nbsp;Ben Johnson ,&nbsp;Daniel Heidenberg ,&nbsp;Mitchell Humphreys ,&nbsp;Karen L. Stern ,&nbsp;Marcelino Rivera ,&nbsp;Kevin M. Wymer","doi":"10.1016/j.urology.2025.02.029","DOIUrl":"10.1016/j.urology.2025.02.029","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the cost-effectiveness of simultaneous vs staged percutaneous nephrolithotomy (PCNL) during treatment of patients with large, bilateral stone burden.</div></div><div><h3>Methods</h3><div>A decision-analytic Markov model was used to assess the cost-effectiveness of simultaneous and staged PCNL for large, bilateral stone burden. Model probabilities and outcomes for index procedures were drawn from a large-volume, single-center cohort. Primary outcomes included costs from a Medicare standpoint with the addition of operative time, length-of-stay costs, effectiveness (quality adjusted life years, QALYs), and incremental cost-effectiveness ratios with a willingness-to-pay threshold of $100,000/QALY.</div></div><div><h3>Results</h3><div>At 1<!--> <!-->year following the index procedure, costs per patient were $52,585 and $61,687 for simultaneous and staged PCNL, respectively. In addition to being less costly, simultaneous PCNL resulted in slightly higher QALYs (0.982) compared to staged PCNL (0.977). On one-way sensitivity analyses, staged PCNL became cost-effective if the stone-free rate increased from 56% to 88% (40% greater per renal unit relative to simultaneous PCNL) or the cost of unilateral PCNL decreased approximately 50% to $4699 ($16,266 less than simultaneous PCNL).</div></div><div><h3>Conclusion</h3><div>Even when assuming a modest reduction in stone-free rate and slightly higher major and minor complication rates at index procedure, simultaneous bilateral PCNL was both less costly and more effective at 1<!--> <!-->year follow up relative to staged bilateral PCNL. This offers further support of simultaneous bilateral PCNL in the proper clinical setting.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 44-50"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524501","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 “Microscopic and Molecular Analysis of the Urethral Plate: A Step Towards Improved Hypospadias Surgery Outcomes”","authors":"Jonathan Balderrama,&nbsp;Renea M. Sturm","doi":"10.1016/j.urology.2025.03.011","DOIUrl":"10.1016/j.urology.2025.03.011","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 151-152"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630854","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 “A Fully Automated Artificial Intelligence-Based Approach to Predict Renal Function after Radical or Partial Nephrectomy”","authors":"Laura Davis ,&nbsp;Michael Lesgart ,&nbsp;Austin Thompson ,&nbsp;Shivaram Cumarasamy ,&nbsp;Kit Yuen ,&nbsp;Danly Omil-Lima","doi":"10.1016/j.urology.2025.03.009","DOIUrl":"10.1016/j.urology.2025.03.009","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 105-106"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633617","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 (Re) evolution in the Treatment of Bladder Cancer","authors":"Juan Pablo Sade ,&nbsp;Federico Ferraris ,&nbsp;Jay Raman","doi":"10.1016/j.urology.2025.03.034","DOIUrl":"10.1016/j.urology.2025.03.034","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 8-10"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693505","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}