Urologia Journal最新文献

{"title":"New masculinities in uro-oncology: A social theory that contributes to the mental health of patients with penile cancer.","authors":"Natalia Barbosa Daza, Daniel Andrés Nieva-Posso, Herney Andrés García-Perdomo","doi":"10.1177/03915603241293840","DOIUrl":"10.1177/03915603241293840","url":null,"abstract":"<p><p>Sociocultural, the penis has represented an essential element in the identity and masculinity of Western men. Therefore, its injury, damage, or loss leads to psychosocial problems affecting these people's health and well-being. Penile cancer is a rare malignancy (it represents 1.44% of the cases of genitourinary cancers) that has direct effects on the genitals, and its treatment consists of penectomy (removal of the penis). The loss of the penis due to this disease has a profound impact on the survivors. It is associated with higher rates of depression, anxiety, and loss of male identity, some even feeling like \"castrated animals\" or fewer men, having not only biological but also social and psychological problems, leading to the loss or decrease of sexual activity, self-esteem, and ability to relate to others. The new masculinities (a social theory much discussed these days) is offered as an alternative to understanding the behavior of men concerning what represents the penis, and the construction of their identity, focusing on the need to reconstruct the idea of masculinity and unlink the identity of men outside their genitals, the discussion of such social elements can be offered alternatives to help improve the psychological condition of patients who have survived the penectomy and contribute significantly to their health and quality of life, especially in improving your mental health.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"324-328"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new approach to repair recurrent vescicourethral anastomotic strictures after radical prostatectomy: The use of prerectal access.","authors":"Antonio Vitarelli, Paolo Minafra, Marco Vulpi, Alberto Piana, Giuseppe Torre, Umberto Carbonara, Lucia Divenuto, Giuseppe Papapicco, Francesco Chiaradia, Stefano Alba, Giuseppe Lucarelli, Michele Battaglia, Pasquale Ditonno","doi":"10.1177/03915603241300877","DOIUrl":"10.1177/03915603241300877","url":null,"abstract":"<p><strong>Background: </strong>Vesicourethral anastomosis stenosis (VUAS) is a well-known complication of prostate cancer treatments, observed in up to 26% of the cases after radical prostatectomy. Conservative management, with single or even repeated transurethral dilation or endoscopic incision of the stenosis, is successful in many cases, but up to 9% of patients are destined to fail after endoscopic treatment. In these cases, a revision of the vesicourethral anastomosis is necessary and can be realized with different surgical approaches. We aim to describe the technique and the outcomes of a new prerectal approach for VUAS repair.</p><p><strong>Methods: </strong>Twelve patients with recalcitrant VUAS following radical prostatectomy were enrolled between May 2014 and September 2018 for prerectal transperineal re-anastomosis. The evaluated outcomes were: the rate of successful anatomical repair at 3 months after surgery and at the last follow-up, postoperative incontinence and complications rate, and the need for further treatments.</p><p><strong>Results: </strong>No major intraoperative complications occurred. After a median follow-up of 46 months (IQR 36-55), 10 patients (83.3%) achieved a good anatomical repair even if one man required an endoscopic urethrotomy, while two patients (16.67%) with a history of pelvic radiotherapy developed a surgical site infection that required toilette and external urinary diversion. Among the others, nine (75%) developed severe stress urinary incontinence, with resolution of their condition. No patient reported significant postoperative pain or fecal incontinence.</p><p><strong>Conclusions: </strong>The prerectal approach to VUAS repair allows direct access to the posterior urethra and the anastomosis, providing a better mobilization of the bladder neck for tension-free anastomosis. However, patients with a history of pelvic radiotherapy have a higher risk of complications. Postoperative incontinence is very common, but urinary continence could be restored with subsequent artificial urinary sphincter placement.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"335-341"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the potential of <i>BOLA3-DT</i> as a diagnostic biomarker in prostate cancer.","authors":"Debansu Sarkar, Badre Alam Khan, Abhishek Bardhan, Amlan Ghosh, Dilip Kumar Pal","doi":"10.1177/03915603251314995","DOIUrl":"10.1177/03915603251314995","url":null,"abstract":"<p><strong>Background: </strong>Exploring the potential of <i>BOLA3-DT</i> as a diagnostic biomarker in prostate cancer.</p><p><strong>Methods: </strong>Expression of the lncRNA <i>BOLA3-DT</i> was analyzed between normal and tumor samples in the GDC TCGA PRAD (Genomic Data Commons: The Cancer Genome Atlas Prostate Adenocarcinoma Collection) dataset. Disease progression-related clinicopathological parameters such as serum PSA level (ng/ml) and Gleason score were associated with the expression of <i>BOLA3-DT</i> using the same GDC TCGA PRAD dataset. To validate these findings, the expression of <i>BOLA3-DT</i> was checked in our sample set of 15 PCa (prostate cancer) and 15 BPH (benign hypertrophy of the prostate) patients.</p><p><strong>Results: </strong>In the GDC TCGA PRAD dataset, the expression of the lncRNA <i>BOLA3-DT</i> was significantly downregulated in prostate cancer tissue samples (<i>n</i> = 492) compared to adjacent normal (<i>n</i> = 52; <i>p</i> < 0.0001), and, there was a significant negative correlation between the expression of the lncRNA <i>BOLA3-DT</i> and the serum PSA level (<i>p</i> < 0.01). However, no significant association was found between the lncRNA <i>BOLA3-DT</i> expression and the Gleason score (<i>p</i> > 0.05). In this study, it was found that <i>BOLA3-DT</i> was downregulated in PCa tissue samples compared to BPH samples (<i>p</i> > 0.05). In the GDC TCGA PRAD dataset, it was revealed that BOLA3-DT could serve as an excellent diagnostic marker with a sensitivity of 86.9% and a specificity of 84.6% (AUC-0.916).</p><p><strong>Conclusion: </strong>LncRNA <i>BOLA3-DT</i>, a novel long non-coding RNA, was found to be downregulated in prostate cancer. The expression of the lncRNA <i>BOLA3-DT</i> can serve as a diagnostic marker in prostate cancer.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"267-272"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the clinical significance of E2F5 expression in circulating extracellular vesicles in prostate carcinoma.","authors":"Noushim Akram Huda, Souvik Chatterjee, Nahid Sultana, Sanghamitra Sengupta, Debansu Sarkar","doi":"10.1177/03915603241313276","DOIUrl":"10.1177/03915603241313276","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific antigen (PSA) based screening strategy has caused a marked improvement in prostate cancer detection and reduction in associated mortality. However, its specificity and sensitivity is not optimal for differentiating different forms of prostate cancer, resulting in overtreatment of indolent tumors. E2F5, a member of the family of transcription factors plays essential roles during many cellular processes. E2F5 amplification is a major event in PCa. A liquid biopsy is a minimally invasive procedure to investigate the cancer-related molecules in circulating tumor cells (CTCs), cell-free DNA, and extracellular vesicles (EVs). Serum and plasma are attractive sources of EV-based biomarkers as blood sample acquisition is a minimally invasive procedure. Given, the shortcomings of PSA as a serum marker, the suitability of E2F5 expression and chemical properties of EVs can be used for the diagnosis of clinically significant prostate cancer.</p><p><strong>Objectives: </strong>To technically refine the current histopathology-based diagnosis of PCa by adding it to the molecular readouts specific to disease states and biochemical fingerprints of EVs.</p><p><strong>Materials and methods: </strong>The study included 100 TRUS-biopsied tissues, 50 representing 4 Gleason grades and another 50 representing BPH. Expression of E2F5 was studied in all the qualified tissues by Immunohistochemistry (IHC). Blood from patients was collected and EVs were isolated and characterized.</p><p><strong>Results: </strong>E2F5 was highly upregulated through all Gleason grades, the maximum being in Gleason 10(5 + 5) and the minimum in Gleason 7(3 + 4), as compared to BPH. The EVs isolated from blood plasma were within 30-200 nm in size.</p><p><strong>Conclusion: </strong>E2F5, being a transcription factor, is highly overexpressed in malignant biopsy tissues, through all Gleason grades. BPH tissues served as control samples. EVs from blood plasma might serve as a potential liquid biopsy marker for predicting disease progression and better prognosis.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"273-281"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TAR-200: Investigational intravesical drug delivery system for bladder cancer.","authors":"Muhammed Munavvir, Mujeeburahiman M, Altaf Khan, Gaurav Das Debashish","doi":"10.1177/03915603251319133","DOIUrl":"10.1177/03915603251319133","url":null,"abstract":"<p><p>Bladder cancer is second among the most common urothelial malignancy and one of the most expensive in terms of treatment. Localized bladder cancer is classified into non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC). First line approach for treatment of NMIBC is transurethral resection of bladder tumor (TURBT) followed by intravesical instillation of immuno/chemotherapeutic agents to prevent or delay recurrence or progression. Historically intravesical Bacillus Calmette Geurin (BCG) instillation has been a mainstay of therapy for NMIBC post-TURBT. Commonly followed drug delivery is intravesical instillation that maximizes exposure of the drug to the lesion and minimizes systemic side effects. Gemcitabine used in bladder cancer due to its pharmacological properties making it appropriate for intravesical instillation. Limitations of intravesical instillation is low bladder permeability leading to decreased drug concentration in bladder tissues and frequent urination causing drug wash out or dilution reducing the effect of treatment. Effective intravesical therapy depends on the penetration of the drug into the tumor. TAR200 is a novel drug delivery system that facilitates sustained release of continuous low dose gemcitabine over an indwelling period providing a uniform concentration of drug after each voiding cycle and exposure of drug to the bladder tumor. There are completed and ongoing clinical trials to evaluate the efficacy of TAR200 alone or in combination with other chemotherapeutic agents in NMIBC and MIBC. FDA has granted breakthrough therapy designation (BTD) for TAR-200 in December 2023. This review highlights the potential of TAR-200 and clinical trials that improve bladder cancer treatment outcome.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"243-251"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for benign uretero-enteric anastomotic strictures after open radical cystectomy and ileal conduit.","authors":"Francesco Pio Bizzarri, Marco Campetella, Pierluigi Russo, Filippo Marino, Filippo Gavi, Francesco Rossi, Nazario Foschi, Emilio Sacco","doi":"10.1177/03915603241303634","DOIUrl":"10.1177/03915603241303634","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Radical Cystectomy (RC) is one of the most common and complex surgical procedures in urologic surgery, and benign ureteroenteric anastomosis strictures (UAS) are complications described in about 15% of patients undergoing RC with different urinary diversion (UD). The aim of this study is to evaluate and analyze risk factors related to the development of ureteral stenosis after RC.</p><p><strong>Materials and methods: </strong>All consecutive patients who underwent RC with ileal conduit from December 2019 to December 2022 were included. According to the guidelines patients with hydronephrosis were investigates with CT-scan or Ultrasound and blood tests at 3-6-12 months and then early. UAS was confirmed with CT-scan and eventually treated with nephrostomies with (with or without descendent pyelography). Several potential risk factor releated to UAS were analyzed by univariate analysis including preoperative, intraoperative and postoperative variables.</p><p><strong>Results: </strong>In total 116 patients were included. At 30 months mean follow up, 21 patients (19%) were diagnosed with UAS. Median time from RC to diagnosis of benign UAS was 6 months (IQR: 4-9). At the univariable analysis previous abdominal surgery (OR 13.5 CI 3.4-63.4, <i>p</i> < 0.001) had the strongest association with shorter time to stricture development and six-fold highest risk of UAS development (OR 6.41, IC 95%; 2.16-21.1, <i>p</i> < 0.001). Also, gender, age, body mass index, lower albumin serum level, higher fibrinogen serum level showed statistically significant association (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Patients with preoperative lower albumin serum level, lower albumin/fibrinogen ratio and higher fibrinogen level are more likely to develop UAS. Moreover, having a history of PAS significantly increases the risk of strictures formation.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"224-230"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Is oral antioxidant (Vit C & E) helpful in minimizing shock wave induced renal damage? A study from a tertiary care Center from eastern India\" A prospective study.","authors":"Praveen Kumar Soni, Krishnendu Maiti, Debansu Sarkar","doi":"10.1177/03915603241312963","DOIUrl":"10.1177/03915603241312963","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal shock wave lithotripsy (ESWL) causes trauma to the renal parenchyma. Due to the kidney injury, free radicals are generated, and an inflammatory process develops. Inflammatory markers like interleukin's (IL), C-reactive protein (CRP), and procalcitonin (PCT) are released into the circulation. Antioxidants have the potential to mitigate the effects of the inflammatory process. Our objectives were the measurement of the effect of supplementation with Vit C and Vit E (antioxidants) and their effect on the reduction of CRP and procalcitonin and further kidney damage.</p><p><strong>Methodology: </strong>There were two groups with 100 patients each. Group A, receiving oral Vitamin E (400 mg twice a day) and oral Vitamin C (500 mg twice a day) beginning 3 days before the lithotripsy and continuing for up to 7 days after the lithotripsy (total of 10 days). Group B served as the control group. Serum levels of CRP and procalcitonin were measured on the day of lithotripsy, day 2, and day 10 post ESWL.</p><p><strong>Results: </strong>In Group B, CRP and PCT values are statistically significantly elevated as compared to Group A. In Group A, pre-ESWL, day 2 and day 10 CRP values are 1.23, 3.58, and 1.61. In Group B pre-ESWL, day 2 and day 10 CRP values are 1.38, 6.70, and 3.09 (<i>p</i> value < 0.001 in day 2 and 10). In Group A, pre-ESWL, day 2 and day 10 PCT values are 0.41, 1.42, and 0.44. In Group B pre-ESWL, day 2 and day 10 PCT values are 0.36, 3.03, and 1.10 (<i>p</i> value < 0.001 in day 2 and 10).</p><p><strong>Conclusion: </strong>The serum levels of the inflammatory marker for acute renal injury are decreased when vitamins C and E are taken orally, which can help to minimize kidney damage after lithotripsy for renal stone disease.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"216-223"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effect of mirabegron on female sexual function in women with overactive bladder.","authors":"Nihat Karabacak, Murat Yavuz Koparal, Kadir Şerefhan Erten, Serhat Çetin, Metin Onaran, İlker Şen","doi":"10.1177/03915603251316699","DOIUrl":"10.1177/03915603251316699","url":null,"abstract":"<p><strong>Background: </strong>Overactive bladder (OAB) is a common syndrome that can negatively affect patients' daily activities, sleep patterns, mental health, sexual function, and general health. In addition to reducing the frequency of attacks, treatment of OAB can be expected to improve the psychological and sexual health of patients.</p><p><strong>Aims: </strong>To evaluate the effects of mirabegron used in the treatment of overactive bladder (OAB) on female sexual function (FSF).</p><p><strong>Methods: </strong>This retrospective study includes 48 sexually active women who were diagnosed with overactive bladder and treated with a daily oral dose of 50 mg mirabegron between November 2021 and March 2022. The evaluation of FSF was conducted using female sexual function index (FSFI) along with urinary parameters before the start of the treatment and at the 6th week of the treatment.</p><p><strong>Results: </strong>In the study, out of 48 participants, 40 (83.3%) were identified with the dry type and 8 (16.7%) with the wet type OAB. The median age when diagnosed was 43.5 years. Although the decrease in the Overactive Bladder Questionnaire (OAB-V8) score did not reach statistical significance in the entire patient group after treatment (<i>p</i> = 0.058), a statistically significant decrease in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score was detected in the wet type OAB group (<i>p</i> < 0.001). During the assessment of sexual function, there was a statistically significant increase in the FSFI score, from 21.4 to 23.05, by the 6th week of treatment (<i>p</i> = 0.017). Specifically, the scores for desire, lubrication, and satisfaction showed a statistically significant post-treatment improvement (<i>p</i> < 0.001, <i>p</i> = 0.049, and <i>p</i> = 0.035, respectively).</p><p><strong>Conclusion: </strong>The study indicates that a 6-week regimen of a daily 50 mg mirabegron dose enhanced sexual function in women. This beneficial impact of mirabegron on sexual health should be taken into account when selecting a treatment for OAB.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"355-360"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophils to lymphocytes ratio as a predictor of BCG response in non-muscle invasive bladder cancer.","authors":"Ahmed Higazy, Amr Elsawy, Ahmed Lofty, Hany M Abdallah, Ahmed Radwan","doi":"10.1177/03915603241308974","DOIUrl":"10.1177/03915603241308974","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the role of preoperative neutrophils to lymphocytes ratio (NLR) as a predictor for the response to BCG in patients with non-muscle invasive bladder cancer (NMIBC).</p><p><strong>Materials: </strong>Nighty six patients with NMIBC were prospectively included in our study. Our study population was classified into two groups, based on pre-operative (NLR) either ⩽ or > 3. After receiving BCG, patients were followed up for 3 years to evaluate the correlation between BCG failure and (NLR).</p><p><strong>Results: </strong>Nighty two patients were evaluated at the end of our study. The NLR > 3 group of patients showed a higher age and T stage compared to the NLR ⩽ 3 group with a significant difference. BCG failure was reported to be higher in the NLR > 3 group with a failure rate of 66.7% compared to 28.3% in the other group (<i>p</i>-value < 0.001). Time to failure in NLR > 3 group compared to NLR ⩽ 3 group was 10.44 ± 4.3 and 15 ± 3.9 months respectively with a (<i>p</i>-value = 0.002). Univariate and multivariate logistic regression revealed that the most significant predictors of BCG failure were NLR > 3, Initial T stage, and age respectively.</p><p><strong>Conclusion: </strong>BCG response is highly affected by the NLR, with a higher failure rate with NLR > 3.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"237-242"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging strategies in tackling antimicrobial resistance in urology: Narrative review and expert opinion.","authors":"Tommaso Ceccato, Simone Botti, Carlo Tascini, Massimiliano Lanzafame, Anna Brugnolli, Lorenzo Ruggera, Orietta Massidda, Vito Racanelli, Truls E Bjerklund Johansen, Tommaso Cai","doi":"10.1177/03915603241310389","DOIUrl":"https://doi.org/10.1177/03915603241310389","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are highly prevalent and frequently treated with antibiotics, making antimicrobial stewardship (AMS) crucial in this field to benefit both individual patients and society. This narrative review examines recent advancements in managing urinary tract infections, focusing on AMS and antimicrobial resistance (AMR). AMS is essential in urology, where antibiotics are frequently prescribed for UTI. AMS promotes optimal antibiotic use to improve patient outcomes, control AMR, and safeguard public health. Key AMS practices in urology include selecting antibiotics at the appropriate dose and duration, especially for uncomplicated UTIs, asymptomatic bacteriuria, and catheter-associated infections. Following evidence-based guidelines, such as those from EAU and the IDSA, helps prioritize narrow-spectrum antibiotics and discourage empirical broad-spectrum use. Regular audits and feedback on antibiotic use help align practices with AMS goals, reducing inappropriate prescriptions. Multidisciplinary AMS teams, including urologists, microbiologists, and pharmacists, enhance treatment precision and antibiotic optimization in complex cases. Reassessing antibiotic therapy based on culture results after 48-72 h enables clinicians to refine treatment, minimizing unnecessary broad-spectrum use and strengthening AMS efforts in urology. In conclusion, addressing AMR in urology requires a careful approach that combines evidence-based antibiotic use, attention to local resistance patterns, and patient-specific factors. Non-antibiotic strategies for recurrent UTI prevention, judicious catheter management, and tailored treatment for complex infections are key AMS components. Emerging technologies in diagnostics and precision medicine offer tools for targeted, personalized therapy, enhancing AMS efforts, and helping to reduce reliance on broad-spectrum antibiotics.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":"92 2","pages":"185-193"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}