Urology最新文献

{"title":"Reply to Editorial Comment on “Surgical Outcomes of the ZSI475 FtM Inflatable Erectile Prosthesis Implantation After Phalloplasty”","authors":"Paul Neuville , Damien Carnicelli , Nicolas Morel-Journel","doi":"10.1016/j.urology.2025.02.003","DOIUrl":"10.1016/j.urology.2025.02.003","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 223-224"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410942","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 Anatomy of the Pediatric Uretero-Pelvic Junction Analysis of Intraoperative Video of Robotic-Assisted Pyeloplasty","authors":"Elizabeth Lynch ,&nbsp;Yi Li ,&nbsp;Laurence S. Baskin","doi":"10.1016/j.urology.2025.01.060","DOIUrl":"10.1016/j.urology.2025.01.060","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the ureteropelvic junction (UPJ) anatomy in children undergoing robotic-assisted pyeloplasty through analysis of high-resolution video.</div></div><div><h3>Materials and Methods</h3><div>Pediatric pyeloplasty recordings were examined, measuring pre- and post-spatulation ureteral diameters. Data on patient demographics, symptoms, hydronephrosis grade, renal function, and UPJ pathology were gathered to compare differences amongst UPJ obstruction etiology.</div></div><div><h3>Results</h3><div>Fifty consecutive robotic pyeloplasties by a single surgeon from over a 3-year period were reviewed, 45 (7 females, 38 males, mean age 5.5 years) were included, excluding two revisions and three poorly recorded cases. 67% had left-sided UPJ obstruction (UPJO). Thirty-one (69%) showed intrinsic UPJ narrowing with significant diameter reduction by an average of 1.1 mm, compared to the proximal ureter, both in vivo and after ureteral spatulation (<em>P</em> &lt;.0001), with mean UPJ-to-normal ureter distance of 4.2 mm. Nine (20%) had crossing vessels, with 63% within 3 mm of the UPJ. Two (4%) had high inserting ureters, and three (7%) had ureteral polyps. Those aged 0-2 years (42%) universally had intrinsic narrowing of the UPJ. In older patients, 50% presented with abdominal/flank pain; among them, 56% with crossing vessels, 33% with ureteral narrowing, and 100% with high insertion. Patients with crossing vessels and polyps exhibited lower average split renal function (34.5% and 26%, respectively) compared to intrinsic narrowing and high insertion groups (both 47%).</div></div><div><h3>Conclusion</h3><div>Robotic pyeloplasty review details UPJ anatomy, emphasizing &gt;1 mm of intrinsic UPJ obstruction narrowing, distance to normal caliber ureter (&lt;8 mm, mean 4.2 mm), crossing vessel proximity (within 1.8 cm of UPJ), and normal ureteral caliber in polyps and high insertions. Analyzing UPJ anatomy offers surgical insights related to etiology, patient age, and presentation.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 135-140"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256754","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":"Reply to Editorial Comment on “Rethinking Low Testosterone in Older Men: Association With Obesity Rather Than Aging”","authors":"Taciana Leonel Nunes Tiraboschi ,&nbsp;Eduardo de Paula Miranda ,&nbsp;Caio Vinicius Suartz ,&nbsp;Cristiano Mendes Gomes ,&nbsp;Jose Bessa Junior","doi":"10.1016/j.urology.2025.02.010","DOIUrl":"10.1016/j.urology.2025.02.010","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 215-216"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459736","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":"Rethinking Low Testosterone in Older Men: Association With Obesity Rather Than Aging","authors":"Taciana Leonel Nunes Tiraboschi ,&nbsp;Eduardo P. Miranda ,&nbsp;Monique Tonani Novaes ,&nbsp;Caroline Santos Silva ,&nbsp;Jean Carlos Zambrano Contreras ,&nbsp;Jarbas de Sá Roriz Filho ,&nbsp;Ernesto Reggio ,&nbsp;Caio Vinícius Suartz ,&nbsp;Cristiano Mendes Gomes ,&nbsp;José de Bessa Junior","doi":"10.1016/j.urology.2024.12.036","DOIUrl":"10.1016/j.urology.2024.12.036","url":null,"abstract":"<div><h3>Objective</h3><div>The decline in testosterone levels among older men remains a subject of debate. While some cross-sectional and longitudinal studies have reported a decrease in testosterone with advancing age, others have not observed this trend. In this study, we aimed to evaluate testosterone levels and identify predictors of low testosterone in an age-stratified cohort of men.</div></div><div><h3>Methods</h3><div>From January 2016 to June 2022, a cohort of men receiving routine care at a primary care center was prospectively analyzed. Participants were stratified into age groups: 45-64 years (middle-aged), 65-74 years (young-old), 75-84 years (middle-old), and ≥85 years (oldest-old). Comprehensive clinical and laboratory assessments were conducted, including waist circumference, glucose levels, triglycerides, HDL cholesterol, and total testosterone. Low testosterone was defined as levels below 300<!--> <!-->ng/dL. Metabolic syndrome was diagnosed in accordance with established diagnostic criteria.</div></div><div><h3>Results</h3><div>The study included 3.489 subjects across age groups. Median testosterone levels were similar across all age groups. The prevalence of low testosterone was around 20% in all groups and did not significantly vary with age. Obesity, as indicated by increased waist circumference (WC) &gt;102 cm, was strongly associated with low testosterone. The prevalence of low testosterone increased from 8% in those with WC<!--> <!-->≤93<!--> <!-->cm to 44% in those with WC<!--> <!-->≥110<!--> <!-->cm.</div></div><div><h3>Conclusion</h3><div>This study highlights the significant association between low testosterone levels and obesity, reinforcing the importance of addressing comorbidities in testosterone decline.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"198 ","pages":"Pages 207-212"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972264","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 \"The Impact of American Board of Urology Certification on Postoperative Outcomes for Patients: Assessing National Trends\".","authors":"Christopher J Kane","doi":"10.1016/j.urology.2025.03.046","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.046","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773483","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 \"Ureteral Tissue Temperature During Ureteroscopy with Ho:YAG Laser Activation in an In Vivo Porcine Model\".","authors":"Joshua Heiman, Vincent G Bird","doi":"10.1016/j.urology.2025.03.044","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.044","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773487","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":"Transitioning to office-based transperineal prostate biopsy - a case study from a regional New Zealand Hospital in economic and environmental sustainability.","authors":"Charlton Martin, Keu Maoate, Ali Hooshyari, Flavio Vasconcelos Ordones, Lodewikus Petrus Vermeulen","doi":"10.1016/j.urology.2025.03.052","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.052","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of the transition to office-based transperineal prostate biopsy (TPPB) on the interconnected domains of profit, planet, and people. Sustainability, encompassing environmental, social, and economic dimensions, is increasingly significant in healthcare. Urology, as a surgical specialty, presents unique opportunities to implement sustainable practices. This article outlines a case study detailing the transition of TPPB from the operating theatre to an office-based setting.</p><p><strong>Methods: </strong>This study utilized a multi-phase approach, integrating retrospective and prospective data analyses. Changes in clinical workflows, financial savings, environmental impacts, and accessibility to care were assessed. Life cycle analysis evaluated carbon emissions associated with TPPB, while clinical outcomes, including infection rates and procedural efficiency, were monitored. Patient satisfaction and equity in healthcare access were explored through geographic accessibility studies and procedural adaptations.</p><p><strong>Results: </strong>Transitioning TPPB to an office-based setting resulted in: 1. Profit: Annual cost reductions of $302,000 NZD, increased procedural capacity, and elimination of hospital admissions due to TRUS-related sepsis. 2. Planet: Reduction in greenhouse gas emissions to 70 kgCO2e per biopsy, with significant contributions from reusable equipment packs and virtual consultations. 3. People: Enhanced patient comfort through fewer biopsy cores, reduced healthcare worker burden, and improved access for Māori populations via proposed mobile biopsy units.</p><p><strong>Conclusions: </strong>This case study underscores the potential for sustainable innovations in urology to achieve cost-effective, environmentally responsible, and socially equitable healthcare delivery. It serves as a model for integrating sustainability into clinical practice, reinforcing the need for data-driven decision-making and collaborative leadership in the medical field.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773528","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.","authors":"Ronald P Miller, Joseph Y Clark","doi":"10.1016/j.urology.2025.03.035","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.035","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744097","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 \"The Change of Detrusor Contractility at 5 Years After Transurethral Resection of the Prostate: A Single-center Prospective Observational Study\".","authors":"Naoya Masumori","doi":"10.1016/j.urology.2025.03.037","DOIUrl":"10.1016/j.urology.2025.03.037","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693517","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":"Effectiveness of Mapping for Cognitive Prostate Biopsy: A Prospective, Randomized Study.","authors":"Murat Kars, Canan Cimsit, Yunus Emre Genc, Ece Bıcakcı, Muhammed Hasan Toper, Kamil Cam","doi":"10.1016/j.urology.2025.03.036","DOIUrl":"10.1016/j.urology.2025.03.036","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of adding a simple prostate mapping diagram to multiparametric prostate magnetic resonance imaging (mpMRI) reports, a randomized, prospective study is designed. Despite cognitive prostate biopsy is the most preferred approach among targeted biopsy methods due to its low cost and easy application, its operator dependency requires standardization to improve diagnostic accuracy for prostate cancer (PCa).</p><p><strong>Methods: </strong>A total of 155 patients underwent mpMRI as the standard of care and were randomly assigned in a 1:1 ratio to two groups: prostate mapping diagram and standard group. In addition to the mpMRI reports, suspicious lesions (≥PI-RADS 3) were drawn on a schematic diagram by a single specialized uro-radiologist in the prostate mapping group. A single experienced urologist sampled four cores from each target in addition to a 12-core systematic biopsy in both groups. A Gleason score of 3+4 or higher was considered as clinically significant PCa (csPCa).</p><p><strong>Results: </strong>Overall cancer detection rate between the group 1 and 2 was statistically significant (57% and 35%, respectively, P=.006). Particularly, csPCa rates among the groups were 47% (36/77) and 21% (16/78) for group 1 and group 2, respectively (P<.001). The csPCa detection with only targeted biopsies was strikingly as high as 3-fold (17% vs 6%, P=.048) in the mapping group.</p><p><strong>Conclusion: </strong>Our prospective study has shown that the addition of a simple mapping strategy to mpMRI reports significantly increased cancer rates by cognitive biopsy. We strongly recommend the use of a schematic mapping diagram in biopsy protocols.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701690","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}