Urologia Journal最新文献

{"title":"Biochemical evaluation of beta-trace protein: A newer glomerular filtration biomarker for early detection and risk assessment of chronic kidney disease over the older creatinine.","authors":"Oras Kadhim Baqer Al-Asadi, Alaa Ibraheem Lazim Alsaedi, Firas S Al-Jabban, Hafidh I Al-Sadi, Ghazi Mohamad Ramadan, Ahmed Mohammed Attyah Zheoat, Haneen Mohanad Mohammed, Lamis Khidher Mohammed","doi":"10.1177/03915603261487649","DOIUrl":"https://doi.org/10.1177/03915603261487649","url":null,"abstract":"<p><strong>Objectives: </strong>Early detection of chronic kidney disease (CKD) is essential for improving clinical outcomes. However, serum creatinine (Scr), the conventional biomarker for estimating glomerular filtration rate (GFR), has notable limitations, particularly in identifying early-stage CKD. This study evaluates beta-trace protein (BTP) as an alternative biomarker for GFR estimation.</p><p><strong>Methods: </strong>In this single-center case-control study, serum creatinine (Scr) and serum BTP were measured in 90 patients with CKD and 70 apparently healthy controls. Measured GFR (mGFR) was determined using the 99mTc-DTPA radioisotope clearance technique as the reference standard, and the diagnostic performance of the two biomarkers was compared by receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Both Scr and serum BTP levels were significantly elevated in CKD patients compared to the control group. Notably, serum BTP exhibited a stronger inverse correlation with measured GFR (mGFR; <i>r</i> = -0.934) than Scr (<i>r</i> = -0.46), indicating superior sensitivity to renal function decline. Receiver operating characteristic (ROC) curve analysis further demonstrated that BTP had higher diagnostic accuracy, with an optimal cutoff concentration of 0.63 mg/L yielding a sensitivity of 98.9%, specificity of 100%, and area under the curve (AUC) of 0.993. In contrast, Scr at 0.775 mg/dL showed lower diagnostic performance (sensitivity = 83.3%, specificity = 42.9%, AUC = 0.74).</p><p><strong>Conclusion: </strong>These findings suggest that BTP may offer improved diagnostic precision and earlier detection of CKD compared to Scr, with potential benefits for more accurate GFR estimation and timely clinical intervention.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261487649"},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991520","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":"Patterns and potential predictors of impaired semen quality: Insights from a retrospective analysis in Al Kharj, Saudi Arabia.","authors":"Mosab A A Alzubier, Tahane Bashir Mohammeddeen Ahmed, Abdulrahman S Binsaleh, Abdulaziz Nasser Alkudam, Talal K Aldawsari, Ghalia Mahfod Aldoseri, Arwa Ibrahim Alwabran, Mohammed Yahya Hanin Alfaifi, Khalid Saad Olayan Almutairi, Abdullah Ali Hussain Awaji","doi":"10.1177/03915603261485845","DOIUrl":"https://doi.org/10.1177/03915603261485845","url":null,"abstract":"<p><strong>Introduction: </strong>Abnormal semen parameters are a significant cause of male infertility, influenced by various lifestyle, medical, and environmental factors. This study aimed to evaluate the prevalence of abnormal semen parameters and explore potential associated factors among patients undergoing semen analysis in Al Kharj area of Saudi Arabia.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at Prince Sattam University Hospital, Al Kharj, Kingdom of Saudi Arabia. Medical records of male patients who underwent semen analysis between March 2021 and December 2024 were reviewed. Data on demographics, lifestyle factors, comorbidities, genitourinary history, semen parameters, hormonal profile, and imaging findings were collected and analyzed using Stata 17.</p><p><strong>Results: </strong>A total of 140 patients were included in the final analysis after excluding 26 with incomplete data. The mean age was 39.9 ± 7.6 years, and the mean BMI was 28.5 ± 4.5 kg/m². Smoking was prevalent in 52.9% of participants, and 17.1% had diabetes or bronchial asthma. Nearly all patients (98.6%) had abnormal semen parameters, with reduced total (mean 38.3%) and progressive motility (mean 17.6%). Azoospermia was observed in one participant. Scrotal ultrasonography, hormonal assessments, and other relevant investigations were variably available.</p><p><strong>Conclusion: </strong>The prevalence of abnormal semen parameters in this cohort was remarkably high. Several lifestyle and medical factors, including smoking, obesity, and chronic illnesses, may contribute to semen abnormalities. Further prospective studies are warranted to elucidate causal relationships and guide targeted interventions.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261485845"},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991560","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":"The Miami Cancer Institute technique: Puboprostatic complex preserving dorsal venous complex ligation with cystourethropexy.","authors":"Deerush Kannan Sakthivel, Pushan Prabhakar, Mohamed Javid Raja Iyub, Orlando Brito Martinez, Arjun Pon Avudaiappan, Murugesan Manoharan","doi":"10.1177/03915603261448785","DOIUrl":"https://doi.org/10.1177/03915603261448785","url":null,"abstract":"<p><p>Urinary incontinence remains a major concern following robot-assisted radical prostatectomy (RARP) and can significantly affect postoperative quality of life. This study describes early continence and oncologic outcomes associated with a surgical approach incorporating puboprostatic ligament (PPL) preservation, selective dorsal venous complex (DVC) ligation, and routine cystourethropexy (the \"Miami Cancer Institute technique\"). We conducted a retrospective analysis of 373 patients who underwent RARP at a tertiary cancer center between January 2017 and December 2023 using this technique. Patients with prior pelvic surgery, preoperative urinary incontinence, or pelvic radiation were excluded. Early urinary continence was defined as complete dryness or use of ⩽1 safety pad per day at 3 months postoperatively. At 3 months, 83.1% of patients achieved continence. The mean operative time was 168.4 min, and mean estimated blood loss was 76.4 ml. Biochemical recurrence, defined as a postoperative PSA ⩾ 0.2 ng/ml confirmed on two measurements, occurred in 6.4% of patients within 1 year and in 15.0% over the entire follow-up period. In this single-surgeon retrospective cohort, the technique was associated with favorable early continence outcomes and acceptable descriptive oncologic surrogate measures. These findings are hypothesis-generating and warrant validation in comparative studies with longer follow-up.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261448785"},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991481","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":"Antidiabetic drug exposure and risk of bladder cancer: A systematic review and meta-analysis.","authors":"William Mathez, Antoine Vincentelli, Iyad Chaoui, Franck Bruyère, Ali Bourgi","doi":"10.1177/03915603261486088","DOIUrl":"https://doi.org/10.1177/03915603261486088","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is associated with an increased risk of bladder cancer, but the impact of specific antidiabetic drug classes remains uncertain.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed/MEDLINE, Embase, Scopus and CENTRAL were searched through 2024 for observational studies assessing the association between antidiabetic drug exposure and incident bladder cancer. Adjusted effect estimates (HRs, RRs, ORs) were pooled using random-effects models. Analyses were performed separately for pioglitazone, metformin and sodium-glucose cotransporter 2 (SGLT2) inhibitors. Heterogeneity was assessed using the <i>I</i>² statistic.</p><p><strong>Results: </strong>Fourteen observational studies including approximately 6.3 million individuals with T2DM were included. Pioglitazone use was not significantly associated with bladder cancer risk (pooled RR ≈ 1.05, 95% CI 0.52-2.09), although substantial heterogeneity was observed (<i>I</i>² = 99%). Several studies suggested a duration and dose-dependent association, particularly with prolonged exposure. Metformin use was associated with a lower risk of bladder cancer (pooled RR = 0.67, 95% CI 0.46-0.98), although substantial heterogeneity was observed. SGLT2 inhibitor use was not associated with an increased risk of bladder cancer (pooled RR = 0.98, 95% CI 0.70-1.37), with moderate heterogeneity across studies (<i>I</i>² = 63%).</p><p><strong>Conclusions: </strong>We did not demonstrate a statistically significant association between pioglitazone use and bladder cancer risk. However, several individual studies suggested a possible duration-dependent effect with prolonged exposure. Metformin use was associated with a lower risk of bladder cancer (pooled RR = 0.67, 95% CI 0.46-0.98), although substantial heterogeneity was observed. SGLT2 inhibitors appear oncologically safe with respect to bladder cancer.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261486088"},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991517","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":"Minimally invasive surgical therapies (MIST) for benign prostatic hyperplasia: Initial single-center experience.","authors":"Kamlesh Gunjan, Vipin Chandra, Naveen Kumar, Saket Singh, Nitish Kumar, Rakesh Kumar, Bhopesh Kadian, Jitendra Jaidiya","doi":"10.1177/03915603261486074","DOIUrl":"https://doi.org/10.1177/03915603261486074","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical therapies (MIST) have emerged as effective alternatives to transurethral resection of the prostate for the management of benign prostatic hyperplasia (BPH), offering symptomatic relief with reduced morbidity and preservation of sexual function. However, real-world data, particularly from Indian centers, remain limited.</p><p><strong>Methods: </strong>This prospective observational study included 20 patients with symptomatic BPH undergoing MIST, comprising Rezūm (<i>n</i> = 14), prostatic urethral lift (UroLift; <i>n</i> = 3), and temporary implantable nitinol device (iTIND; <i>n</i> = 3). Patients with moderate-to-severe lower urinary tract symptoms (LUTS) or catheter-dependent urinary retention were included. Outcomes assessed at 1, 3, and 6 months included International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), erectile function (IIEF-5), catheter status, and complications.</p><p><strong>Results: </strong>The mean age was 66.2 years, and mean prostate volume was 43 g. Ten patients (50%) presented with catheter-dependent urinary retention. Mean IPSS improved from 22.9 preoperatively to 11.2 at 6 months, while mean Qmax increased from 9.1 mL/s to 16.3 mL/s. Among catheter-dependent patients, 9/10 (90%) achieved successful trial without catheter. Erectile function remained stable in patients undergoing UroLift and iTIND procedures. One patient (5%) required secondary intervention (TURP) due to failed Rezūm therapy. No major complications were observed.</p><p><strong>Conclusion: </strong>MIST procedures, including Rezūm, UroLift, and iTIND, provide significant improvement in urinary symptoms and flow with excellent safety and preservation of sexual function. These therapies are effective even in selected patients with urinary retention and represent viable alternatives to conventional surgery.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261486074"},"PeriodicalIF":1.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901218","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":"Are urologists prepared for transgender health care? Evidence of knowledge and confidence gaps.","authors":"Hector Rodrigo Gonzalez-Carranza, Nestor Saucedo-Conrado, Luis Antonio Reyes-Vallejo","doi":"10.1177/03915603261481563","DOIUrl":"https://doi.org/10.1177/03915603261481563","url":null,"abstract":"<p><strong>Purpose: </strong>Transgender individuals experience significant disparities in healthcare access and quality, often owing to limited provider training and awareness. This study aimed to assess the knowledge, attitudes, and clinical exposure of Mexican urologists and urology residents in relation to transgender patient care and to identify potential gaps that may affect treatment quality and access.</p><p><strong>Methods: </strong>An anonymous survey was distributed to board-certified urologists and urology residents between April and May 2025. The questionnaire included a 5-point Likert scale to evaluate participants' knowledge, confidence, and comfort when treating transgender patients. The questions also assessed clinical experience, familiarity with gender identity and appropriate pronouns, ability to provide endocrine and surgical care, and awareness of healthcare disparities. A total of 322 responses were analyzed using descriptive statistics and t-tests to identify significant trends.</p><p><strong>Results: </strong>Among the respondents, 53.7% had never attended to a transgender patient, and 71.1% were not currently caring for any. Only 15.5% reported a strong knowledge base in transgender health and only 7.4% felt confident in performing gender-affirming surgery. While 62.1% felt comfortable discussing gender identity, only 58.3% could clearly distinguish it from their sexual orientation. Urology residents reported greater comfort and awareness than certified urologists did. Less than half (48.4%) strongly supported transgender care in residency programs.</p><p><strong>Conclusion: </strong>There is a marked gap in transgender-related knowledge and clinical exposure between Mexican urologists and residents. These findings underscore the urgent need to integrate structured transgender health education into urological training and continuing medical education to promote equitable, competent, and inclusive care.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261481563"},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888394","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":"Patient-centered outcomes of double-J ureteral stents: Symptom frequency and satisfaction in a resource-limited healthcare system.","authors":"Abdulrahman Jaber, Haitham Kayal, Hadeel Nicola, Seba Naamneh, Hatim Hijaz, Ramzi Shawahna","doi":"10.1177/03915603261481561","DOIUrl":"https://doi.org/10.1177/03915603261481561","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to quantify the prevalence and severity of indwelling double-J (DJ) ureteral stent-related symptoms, characterize pain perception, and evaluate patient satisfaction among adult patients in a resource-limited healthcare system, while identifying demographic and clinical factors associated with symptom burden and satisfaction.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between April and December 2025 at two major urology centers. Patients who underwent DJ ureteral stenting for ureteral obstruction, predominantly due to urinary tract stones, were consecutively recruited. Data were collected using a structured, seven-part questionnaire assessing urinary symptoms, pain characteristics, quality of life, and satisfaction, supplemented by clinical information from electronic medical records. Pain intensity was measured using a visual analogue scale (VAS).</p><p><strong>Results: </strong>Among 200 patients analyzed, stent-related symptoms were highly prevalent. The median stent indwelling duration was 30.0 days [IQR: 19.0-41.0]. Flank or abdominal pain was reported by 176 patients (88%), with a median severity of 6.0 on the VAS. Other frequent complaints included fatigue (74%), sleep disturbance (71.5%), urinary frequency (70.5%), dysuria (69%), hematuria (58%), and sensation of a foreign body (65.5%). Despite this substantial symptom burden, overall satisfaction was relatively high: 124 patients (62%) reported being satisfied or very satisfied, and 134 (67%) expressed willingness to undergo stenting again if medically indicated. Longer stent indwelling time was independently associated with increased flank pain (OR 1.05/day, 95% CI 1.01-1.09, <i>p</i> = 0.007) and satisfaction was negatively associated with comorbidities (β = -0.17, <i>p</i> = 0.027).</p><p><strong>Conclusion: </strong>DJ ureteral stents cause significant pain, urinary symptoms, and quality-of-life impairment among Palestinian patients, yet overall satisfaction remains high, reflecting recognition of their clinical necessity. These findings highlight the need for better counseling, tailored symptom management, and structured follow-up to strengthen patient-centered care.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261481561"},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888436","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":"Comparing local versus spinal anesthesia for transurethral cystolithotripsy: A retrospective review of efficacy, safety, and pain outcomes.","authors":"Mahendra Singh, Vishal Prashar, Shreya Sharma, Deepak Prakash Bhirud, Shiv Charan Navriya, Gautam Ram Choudhary, Arjun Singh Sandhu","doi":"10.1177/03915603261481564","DOIUrl":"https://doi.org/10.1177/03915603261481564","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary bladder stones cause significant morbidity and are increasingly treated by transurethral holmium laser cystolithotripsy (TULC), a minimally invasive procedure. While spinal anesthesia is commonly used, local anesthesia is gaining interest, especially for high-risk or elderly patients. This study compares the safety, efficacy, and outcomes of TULC under local versus spinal anesthesia.</p><p><strong>Methods: </strong>A retrospective observational study at AIIMS, Jodhpur, India (March 2023-March 2025) included 81 bladder stone patients undergoing TULC. 43 received local anesthesia and 38 spinal anesthesia. Data on demographics, stone size and number, operative time, pain scores (Visual Analogue Scale), complications, and stone clearance were analyzed.</p><p><strong>Results: </strong>Both groups were comparable in age and sex. Mean stone size was smaller in the local anesthesia group (22 mm) compared to spinal anesthesia (30 mm); multiple stones were more common with spinal (26.3% vs 9.3%). Complete stone clearance was achieved in all patients. Operative time was shorter under local anesthesia (45.3 vs 55 min). Pain scores were similar (VAS 3.69 vs 3.70). Minor complications, such as hematuria and fever, occurred but resolved conservatively. No major complications or mortality were reported. Patient satisfaction was slightly lower with local anesthesia (Likert 4.05 vs 4.13).</p><p><strong>Conclusions: </strong>Holmium laser cystolithotripsy is safe and effective under both local and spinal anesthesia. Local anesthesia is a well-tolerated alternative for smaller stones, offering a quicker procedure with similar pain outcomes. Spinal anesthesia remains preferred for larger or multiple stones. Further randomized studies are needed to optimize anesthesia selection criteria.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261481564"},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888456","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":"Surgical sperm retrieval in cases with non obstructive azoospermia, comparative study between maldescended and normal positioned testis.","authors":"Nashat Nabil Ismaeil, Wael Mohamed Ahmed Zohdy, Ahmad Mohamed Elsadat, Mohamed Adel Abd Allah, Ahmed Ragab","doi":"10.1177/03915603261464708","DOIUrl":"https://doi.org/10.1177/03915603261464708","url":null,"abstract":"<p><strong>Background: </strong>Non-obstructive azoospermia (NOA) is absent sperm due to defective spermatogenesis from causes like cryptorchidism, genetics, or unknown factors.</p><p><strong>Aim: </strong>to compare surgical sperm retrieval rate in NOA between men with normally positioned scrotal testis/testes and undescended testis/testes.</p><p><strong>Patients and methods: </strong>This retrospective study included 869 men with NOA who underwent m-TESE between October 2016 and October 2023 at Beni-Suef University Hospital and IVF centers in Beni-Suef and Giza. After excluding 41 cases with confounding factors, 777 had scrotal testes and 92 had undescended testes (UDT) and were included in the analysis.</p><p><strong>Results: </strong>The study included 869 men with non-obstructive azoospermia (NOA) undergoing microdissection testicular sperm extraction (m-TESE), 777 (89.9%) had normally positioned scrotal testes, and 92 (10.1%) had undescended testes (UDT) [66 inguinal, 24 abdominal, 2 mixed]. Men with scrotal testes had higher testicular volume and E2 levels, but lower FSH and LH levels than UDT cases. Sperm retrieval rate (SRR) was significantly higher in scrotal testes (36.8%) compared to UDT (23.9%, <i>p</i> = 0.015), with no sperm retrieved from abdominal or mixed testes. Inguinal testes had an SRR of 33.3%. Earlier orchidopexy (12.4 ± 9.4 years) was associated with higher SRR (37.2% vs 12.2%, <i>p</i> = 0.007) compared to later orchidopexy (24.9 ± 13.8 years). Unilateral UDT showed higher SRR (40%) than bilateral (17.9%, <i>p</i> = 0.0517).</p><p><strong>Conclusion: </strong>Higher SRR was seen in scrotal and inguinal testes, especially when orchidopexy was done before 16.5 years. Abdominal testes showed no sperm, and genetics had no clear effect.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261464708"},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888463","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":"Andrological emergencies in current emergency medicine: A narrative overview of clinical, psychological, and worldwide implications.","authors":"Ghada Farouk Mohammed, Mohammed Saleh Al-Dhubaibi, Saleh Salem Bahaj, Ahmed Mohammed Al-Dhubaibi, Sameh Saad Aziz, Yasser Salem N Saleh","doi":"10.1177/03915603261481575","DOIUrl":"https://doi.org/10.1177/03915603261481575","url":null,"abstract":"<p><strong>Background: </strong>Andrological emergencies (AEs) constitute a critical subset of acute urogenital conditions requiring urgent recognition and intervention to preserve sexual and reproductive function while preventing long-term morbidity. Common AEs include testicular torsion, ischemic priapism, penile fracture, paraphimosis, Fournier's gangrene, penile strangulation, and acute urinary retention.</p><p><strong>Aim: </strong>To provide a comprehensive synthesis of current knowledge on the clinical presentation, diagnostic approaches, therapeutic strategies, psychosocial implications, ethical considerations, and global disparities.</p><p><strong>Methods: </strong>A narrative review of peer-reviewed literature was conducted across major medical databases. Evidence was integrated thematically to highlight clinical features, diagnostic tools, management strategies, and broader psychosocial and health system impacts.</p><p><strong>Outcomes: </strong>Key outcomes included improved understanding of diagnostic accuracy, therapeutic efficacy, psychosocial burden, ethical considerations, and inequities in access to timely care.</p><p><strong>Results: </strong>AEs present across all age groups with distinct clinical signs necessitating rapid recognition. Doppler ultrasound and timely surgical intervention remain central for testicular torsion, while aspiration with intracavernosal sympathomimetics represents first-line management for ischemic priapism. Early surgical repair is essential in penile fracture and paraphimosis. Delayed presentation, often due to stigma and embarrassment, significantly worsens prognosis. Ethical challenges, particularly regarding informed consent in emergencies, are frequently encountered. Global disparities in healthcare access and provider training contribute to heterogeneous outcomes, particularly in low-resource settings.</p><p><strong>Clinical implications: </strong>Optimal management of AEs requires multidisciplinary expertise, incorporation of sensitive psychosocial care, and equitable access to emergency services.Strengths and limitations:This review integrates clinical, psychosocial, ethical, and global health perspectives on AEs, offering a holistic view. However, reliance on heterogeneous data and limited comparative studies constrain definitive conclusions.</p><p><strong>Conclusion: </strong>The timely recognition and management of AEs are essential to preserve function and quality of life. Addressing psychosocial barriers, ethical complexities, and healthcare disparities will require patient-centered education, enhanced provider training, and international collaboration to establish standardized, globally adaptable emergency protocols.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261481575"},"PeriodicalIF":1.3,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866951","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}