Urology Annals最新文献

{"title":"Prevalence and management of testicular incidentaloma in men with male factor infertility: Experience of a high-volume tertiary center.","authors":"Ahmad A Aboukhshaba, Abdulaziz M Almalki, Faisal G Alzahrani, Omar N Alfehaid, Hassan A Altalag, Abdulkareem Aloqbawi, Abdulrahman Alsuwailim, Mohamed S Kattan, Said A Kattan, Naif K Alhathal","doi":"10.4103/ua.ua_97_25","DOIUrl":"https://doi.org/10.4103/ua.ua_97_25","url":null,"abstract":"<p><strong>Background: </strong>Testicular lesions most frequently present as palpable testicular masses. Interestingly, the identification of impalpable small testicular masses in patients with male factor infertility is occurring increasingly frequently, most probably due to the widespread use of testicular ultrasonography. In this study, we aim to provide insight into the likelihood of small incidentally found testicular masses and the recommended primary management.</p><p><strong>Materials and methods: </strong>This is a retrospective study of 2680 infertile men with evidence of testicular lesion <2 cm incidentally found on ultrasound during infertility evaluation.</p><p><strong>Results: </strong>A total of 20/2680 (0.74%) of patients had an intraoperative frozen section due to an incidental testicular lesion. Eighty percent (16/20) found out to be Leydig cell hyperplasia, 15% were Leydig cell benign tumors, and 5% were benign hemangioma.</p><p><strong>Conclusion: </strong>Reassurance and observation are recommended for the small (<2 cm) incidental testicular lesion found during male infertility evaluation.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"157-161"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of buccal mucosa graft versus inner preputial flap substitution urethroplasty for long-segment anterior urethral stricture: A retrospective cohort study.","authors":"Bhavyadeep Korrapati, Vijayanand Mani, Velmurugan Palaniyandi, Hariharasudhan Sekar, Sriram Krishnamoorthy, Vivek Meyyappan","doi":"10.4103/ua.ua_140_25","DOIUrl":"https://doi.org/10.4103/ua.ua_140_25","url":null,"abstract":"<p><strong>Introduction: </strong>Long bulbar urethral strictures not amenable to excision and primary anastomosis are best managed with substitution urethroplasty. Buccal mucosa grafts (BMGs) and inner preputial flaps (IPFs) are the most established options, each with advantages and limitations.</p><p><strong>Materials and methods: </strong>A total of 100 patients (age 26-62 years, mean stricture length 3.5 cm) underwent single-stage dorsal onlay substitution urethroplasty using either BMG (<i>n</i> = 60) or IPF (<i>n</i> = 40). Preoperative evaluation included retrograde urethrography, uroflowmetry (Qmax), postvoid residual volume, and questionnaires (International Prostate Symptom Score [IPSS]; International Index of Erectile Function-5). Surgical success was defined as Qmax ≥15 mL/s, IPSS <8, and no obstructive symptoms or re-intervention. Patients were followed at 6 and 12 months. Stricture-free survival was analyzed using Kaplan-Meier estimates.</p><p><strong>Results: </strong>Both groups demonstrated significant improvement in urinary flow and symptom scores at follow-up, with preservation of erectile function. At 6 months, composite surgical success was observed in 85% of patients undergoing BMG urethroplasty and 78% of those undergoing IPF urethroplasty (<i>P</i> = 0.09). At 12 months, stricture-free survival was 92% in the BMG group and 84% in the IPF group (log-rank <i>P</i> = 0.12). Complication rates were low and comparable between groups, with no Clavien-Dindo grade ≥ III events.</p><p><strong>Conclusion: </strong>Both BMG and IPF urethroplasty achieve excellent 1-year outcomes. BMG shows a trend toward greater durability and technical simplicity, whereas IPF remains a valuable option when oral harvest is contraindicated.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"186-197"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the loop on catheter-associated urinary tract infections: A prospective risk assessment and scoring system for the early prediction and prevention of catheter-associated urinary tract infection.","authors":"Rajan Ravichandran, Roshan Yedulla Reddy, Velmurugan Palaniyandi, Hariharasudhan Sekar, Sriram Krishnamoorthy","doi":"10.4103/ua.ua_86_25","DOIUrl":"https://doi.org/10.4103/ua.ua_86_25","url":null,"abstract":"<p><strong>Background: </strong>Catheter-associated urinary tract infections (CAUTI) are among the most common healthcare-associated infections, particularly in hospitalised patients requiring prolonged catheterisation. Despite standard protocols, preventable lapses in catheter care and clinical practices contribute to the incidence of these infections.</p><p><strong>Aims and objectives: </strong>This study aimed to identify significant risk factors and develop a point-based CAUTI Risk Scoring System for early prediction and intervention.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted over six months at a tertiary care hospital, including 100 catheterized adult inpatients. Demographic data, Clinical variables, and catheter practices were documented. CAUTI was confirmed by urine culture. A risk stratification model was developed by assigning weighted scores to statistically significant variables, categorising patients into low, moderate, and high CAUTI risk groups. A domain-wise heatmap visually represented the novelty and interdisciplinary relevance of the study's contributions across ten clinical research domains.</p><p><strong>Results: </strong>Among the 26% of study participants who had CAUTI overall, the important procedural predictors were open-type drainage systems (p < 0.00001), kinking of catheter tubing (p < 0.00001), and raised urobag placement (p < 0.00001). Clinical risk variables included diabetes mellitus (p = 0.00001), catheter duration greater than 7 days (p = 0.0043), female sex (p = 0.0023), and immobility (p = 0.0014). Strong early signals included turbid urine (p = 0.00004) and unexplained fever (p = 0.00001). A cumulative risk rating system placed patients into low (0-3), moderate (4-6), and high-risk (≥7) categories.</p><p><strong>Conclusions: </strong>This study presents the first validated CAUTI Risk Scoring System, including clinical, procedural, and early bedside indicators. The scoring tool enables proactive intervention and serves as a necessary adjunct to infection prevention plans in hospital environments.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"127-140"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Vitamin D deficiency and its association with lower urinary tract symptoms among women in Saudi Arabia.","authors":"Abdullatif K Almaghlouth, Ali Fahmi Alkhars, Zainab Ibrahem Albeladi, Abdulelah Bader Alshafei, Manar Abaas Alhejji, Fatimah Ibrahim Albeladi, Eman Abdulaziz Albeshr, Jumanah Abdulaziz Almas, Jomana Hussain Alali","doi":"10.4103/ua.ua_71_25","DOIUrl":"https://doi.org/10.4103/ua.ua_71_25","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency is highly prevalent globally and has been linked to lower urinary tract symptoms (LUTS). In Saudi Arabia, this relationship in women has not been fully explored.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted among 386 Saudi women aged ≥18 years using a self-administered online survey. Data included sociodemographics, LUTS (assessed via the Bristol Female LUTS questionnaire), and self-reported Vitamin D status and supplementation. Associations between Vitamin D deficiency and LUTS were analyzed using Chi-square tests.</p><p><strong>Results: </strong>Physician-diagnosed Vitamin D deficiency was reported in 82.4% of participants. Severe deficiency was observed in 30.2%, moderate in 27.4%, and mild in 19.5%. Significant associations were found between severe deficiency and delayed urination (50.0% never experienced vs. 66.4% in mild/moderate deficiency and 71.2% in normal Vitamin D; <i>P</i> = 0.010) and straining to void (58.3% never experienced vs. 71.1% and 65.8%; <i>P</i> = 0.049). Paradoxically, 28.1% of women with severe deficiency reported ease in stopping urine flow, compared to 13.4% in mild/moderate deficiency and 20.5% in normal levels (<i>P</i> = 0.028). Supplementation effects varied: 49.4% reported no change, 30.2% slight improvement, and 19.2% considerable improvement, often requiring more than 2 months. Most demographic factors were not significantly associated with deficiency.</p><p><strong>Conclusion: </strong>Vitamin D deficiency affects 82.4% of Saudi women, increasing the odds of delayed urination and straining to void by 1.5-1.8 times. Supplementation improved urinary symptoms in 49.4% of women, often requiring more than 2 months, emphasizing the need for routine screening, tailored supplementation, and public health interventions to reduce LUTS.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"118-126"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent genital arousal disorder: A systematic review of diagnosis, etiology, and treatment approaches (2015-2025).","authors":"Prasenjit Bhowmik, Muhammad Umair Shafiq, Layla Sultan, Mustafa Ahmad, Abdulla Khaleel Alawadi, Sachin Yallappa","doi":"10.4103/ua.ua_157_25","DOIUrl":"https://doi.org/10.4103/ua.ua_157_25","url":null,"abstract":"<p><p>Persistent genital arousal disorder (PGAD) is a distressing, often debilitating condition of unwanted genital arousal occurring independent of desire and difficult to relieve, with substantial psychosocial burden. We systematically reviewed peer-reviewed studies (2015-2025) to synthesize the evidence for diagnosis, etiology, and treatment. PubMed, Ovid (MEDLINE/Embase), and CINAHL (English-language, human studies; last searched on August 31, 2025) were searched. Two reviewers independently screened the records and extracted data, with disagreements resolved by the consensus and third-reviewer adjudication. Risk of bias was assessed using ROBINS-I for comparative observational studies and Joanna Briggs Institute tools for case series. The findings were synthesized narratively in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The review protocol was registered prospectively in PROSPERO (CRD420251108714). Of 799 records identified, 56 duplicates were removed; 743 titles/abstracts were screened, 197 full texts were assessed, and 14 studies were included. Eligible designs comprised cross-sectional surveys, case-control/cohort studies, case series ≥3 patients, and one clinical review with embedded cases; no randomized controlled trials (RCTs) were identified. Owing to clinical and methodological heterogeneity, meta-analysis was not performed. Participants were predominantly women. Diagnostic practice was inconsistent: Most used symptom-based criteria aligned to International Society for the Study of Women's Sexual Health or Leiblum-Nathan frameworks, variably combined with targeted imaging, neurophysiology, or small-fiber testing. Etiologic signals most often implicated neuropathic/structural mechanisms - sacral radiculopathy, Tarlov cysts, and pudendal or small-fiber neuropathy - alongside central neurobiological and psychosocial contributors. Interventions included pelvic-floor physiotherapy, cognitive-behavioral approaches, pharmacologic agents (e.g., gabapentinoids and benzodiazepines), neuromodulation, and selected surgical decompressions for defined lesions; outcomes were mixed and follow-up/safety reporting limited. Overall, PGAD appears multifactorial and under-standardized in assessment. It should be prioritized to include a consensus, multimodal diagnostic pathway and prospective, comparative studies using validated patient-reported outcomes to inform individualized, evidence-based care.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"95-105"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional and physical discomfort in urodynamic studies: A questionnaire-based assessment in a Middle Eastern population.","authors":"Razan Almesned, Sultan Alrashidi, Omar Alsulaiman, Samia Alhashmi, Waleed Altaweel","doi":"10.4103/ua.ua_19_25","DOIUrl":"https://doi.org/10.4103/ua.ua_19_25","url":null,"abstract":"<p><strong>Introduction: </strong>Urodynamic study (UDS) is a valuable diagnostic test in urological practice. Due to the nature of the test, patients may experience emotional and physical discomfort. Mixed information exists on the degree of emotional and physical discomfort and their association with age, sex, body mass index, prior explanation, use of clean intermittent catheterization (CIC), and presence of a neurogenic bladder.</p><p><strong>Methods: </strong>Over a period of 7 months, all patients undergoing UDS in our department were included in this study. Two self-completed anonymous questionnaires were distributed before and immediately after the test. Basic epidemiological as well as medical information was collected. A Likert score of 0-5 was used to rate the levels of anxiety, embarrassment, and pain prior to and after the test. Statistical analysis was done to identify factors that can influence the emotional and physical experience.</p><p><strong>Results: </strong>A total of 65 patients completed the questionnaire. Higher levels of emotional and physical discomfort before and after the procedure were experienced by patients who underwent UDS for the first time. Patients reported significantly lower levels of anxiety, embarrassment, and pain after the procedure compared to their anticipated levels before the procedure, <i>P</i> = 0.0002, 0.029, and 0.003, respectively. Patients using CIC reported lower levels of anxiety and anticipated pain (<i>P</i> = 0.0002 and 0.03). The presence of a neurogenic bladder was associated with lower levels of anxiety and embarrassment (<i>P</i> = 0.002 and 0.03).</p><p><strong>Conclusion: </strong>Emotional and physical discomfort is experienced by most patients undergoing UDS which leads to hesitancy in agreeing to proceed with the test. Our results showed that UDS is well tolerated, with experienced discomfort lower than expected. Having a neurogenic bladder and using CIC were predictors of lower emotional discomfort.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"106-110"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the efficacy of alfuzosin and mirabegron on symptoms associated with Double-J stent placement after retrograde intrarenal surgery.","authors":"Mehmet Öztürk, Ferhat Taskir, Sakip Erturhan, Onur Zeytun, Omer Bayrak, Ilker Seckiner","doi":"10.4103/ua.ua_91_25","DOIUrl":"https://doi.org/10.4103/ua.ua_91_25","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the efficacy of alfuzosin, mirabegron, and their combination in terms of stone-free rates, residual fragments, stent-related pain, and lower urinary tract symptoms (LUTS) in patients undergoing Double-J (DJ) stent placement following retrograde intrarenal surgery (RIRS).</p><p><strong>Materials and methods: </strong>A prospective, randomized, single-center trial was conducted between February 2022 and December 2023 at Gaziantep University. A total of 103 patients who underwent RIRS for unilateral renal stones measuring 1-2 cm followed by DJ stenting were enrolled. Patients were randomized into four groups: Group 1 (control group, no medication), Group 2 (alfuzosin 10 mg/day), Group 3 (mirabegron 50 mg/day), and Group 4 (combination therapy with alfuzosin and mirabegron). Pain and LUTS were assessed 30 days postoperatively using the Visual Analog Scale (VAS) and the Overactive Bladder-Validated 8 (OAB-V8) questionnaire.</p><p><strong>Results: </strong>The mean age was 43.55 ± 13.93 years. No statistically significant difference was found between groups with respect to stone-free rates, residual stones, pain, or LUTS (<i>P</i> > 0.05). Group 2 (alfuzosin) had the lowest mean VAS (1.69 ± 1.52) and OAB-V8 (13.5 ± 7.37) scores; however, these differences were not statistically significant when compared to the control group (<i>P</i> = 0.112 and <i>P</i> = 0.592, respectively). Residual stones were detected in 15.5% of patients, and stone size was identified as a significant predictor (<i>P</i> = 0.025).</p><p><strong>Conclusions: </strong>The use of alfuzosin and mirabegron, either alone or in combination, did not have a significant effect on stone-free rates, stent-related pain, and LUTS. Although lower pain and symptom scores were observed in the alfuzosin group, these findings should be interpreted with caution due to the lack of statistical significance. The relatively small sample size and single-center design represent important limitations of this study. Further large-scale, multicenter studies are warranted to clarify the potential role of these agents in the management of DJ stent-related symptoms.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"141-147"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of laparoscopic genitourinary fistula repair: A single-center study.","authors":"Ajaybhai Jani, Amit Jain, Narendra Singh Kurmi, Sameer Vyas, Saurabh Jain, Saurabh Kumar, Skandh Bhatia","doi":"10.4103/ua.ua_139_25","DOIUrl":"https://doi.org/10.4103/ua.ua_139_25","url":null,"abstract":"<p><strong>Background: </strong>Genitourinary fistulas, though rare, are serious complications predominantly following gynecological surgeries. Minimally invasive laparoscopic techniques have emerged as effective alternatives to open repair, offering faster recovery and reduced morbidity.</p><p><strong>Objective: </strong>The purpose of this study is to report the surgical outcome of laparoscopic genitourinary fistula repair performed at our institution.</p><p><strong>Materials and methods: </strong>Fifty-eight consecutive patients who underwent laparoscopic genitourinary fistula repair at the Department of Urology, Gandhi Medical College, Bhopal, India, from December 2018 to January 2025, were included in this study. The study was conducted retrospectively by analyzing data from a prospectively maintained institutional medical records database. Among those patients, 30 had vesicovaginal fistula (VVF), 26 had ureterovaginal fistula (UVF), and 2 had vesicouterine fistula (VUF). Patients were assessed preoperatively with imaging and cystoscopy and underwent standardized laparoscopic repair based on fistula type. Outcome measures included success rate, recurrence, complications, perioperative parameters, and postoperative recovery parameters. Statistical analysis was descriptive.</p><p><strong>Results: </strong>Laparoscopic repair of 30 supratrigonal VVF, 26 UVF, and 2 VUF was performed. VVF was associated with abdominal hysterectomy in 20 patients, vaginal hysterectomy in 4 patients, and lower segment cesarean section (LSCS) in 6 patients. UVF was associated with abdominal hysterectomy in 22 patients, vaginal hysterectomy in 2 patients, radical hysterectomy in 1 patient, and LSCS in 1 patient. Both cases of VUF were associated with LSCS. The mean size of the VVF was 15 mm. One intraoperative bowel injury occurred during laparoscopic VVF repair and was successfully managed using the Heineke-Mikulicz repair. Two cases of VVF developed recurrence; both the cases were successfully managed with open VVF repair 3 months after the diagnosis. The success rates of VVF, UVF, and VUF were 93.33%, 100%, and 100%, respectively.</p><p><strong>Conclusion: </strong>Laparoscopic genitourinary fistula repair is a reliable and effective treatment modality with high success rates and minimal morbidity. With appropriate patient selection, meticulous preoperative evaluation, and adherence to sound surgical principles, laparoscopic repair is a feasible and effective option in centers with laparoscopic expertise.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"171-178"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term risk of renal impairment after complete primary repair of classic bladder exstrophy.","authors":"Mohamed Emad Eldin, Ahmed A Shahat, Ahmed A Elderwy, Alaa E Abdelmoneim","doi":"10.4103/ua.ua_155_25","DOIUrl":"https://doi.org/10.4103/ua.ua_155_25","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the long-term risk of renal impairment and the factors influencing renal function after complete primary repair of classic bladder exstrophy (CBE).</p><p><strong>Materials and methods: </strong>A retrospective review was conducted for 66 patients with CBE (50 males, 16 females) who underwent complete primary repair between 1998 and 2024. The median follow-up time was 83.5 months (range, 12-324 months). A <i>post hoc</i> power analysis (α =0.05, <i>n</i> = 66, effect size = 0.5) showed a power of 0.98. The primary outcome was the estimated glomerular filtration rate (eGFR) at the final follow-up, with renal impairment defined as < 60 mL/min/1.73 m². Univariate and multivariate analyses assessed associations between renal impairment and key clinical factors.</p><p><strong>Results: </strong>The median eGFR at the last follow-up was 112.4 mL/min/1.73 m² (range 37.31-147.7). Four patients (6.1%) developed renal impairment. Severe hydronephrosis (<i>P</i> = 0.003), high-grade vesicoureteral reflux (<i>P</i> = 0.003), febrile urinary tract infection (UTI) (<i>P</i> = 0.008), and smaller bladder capacity (<i>P</i> = 0.032) were significantly associated with impaired renal function. Multivariate analysis identified severe hydronephrosis (<i>P</i> = 0.025; odds ratio [OR] 33.8) and febrile UTI (<i>P</i> = 0.033; OR 6.34) as independent predictors.</p><p><strong>Conclusions: </strong>Long-term renal function remained stable in most patients after complete primary repair of CBE, although 6% experienced renal impairment. Severe hydronephrosis, high-grade reflux, febrile UTI, and reduced bladder capacity were essential predictors, emphasizing the need for close monitoring and timely management.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"179-185"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond catheter-associated urinary tract infection: A prospective study of infectious, noninfectious, and psychosocial risks of indwelling catheters.","authors":"Roshan Reddy, Rajan Ravichandran, Velmurugan Palaniyandi, Hariharasudhan Sekar, Sriram Krishnamoorthy","doi":"10.4103/ua.ua_114_25","DOIUrl":"https://doi.org/10.4103/ua.ua_114_25","url":null,"abstract":"<p><strong>Background: </strong>Indwelling urethral catheters (IUCs) are indispensable in modern urology; however, prolonged dwell times increase the risk of infection and patient-reported morbidity. Evidence-based stewardship, therefore, requires risk estimates by catheter material and dwell duration.</p><p><strong>Methods: </strong>We conducted a prospective, single-center cohort study from July to December 2023. Consecutive adults who received an IUC were followed until its removal. Dwell was stratified as ≤5, 6-14, 15-30, and >30 days. A baseline urine culture was collected within 24 h of insertion. Follow-up cultures were planned for day 7 or at removal, and symptom-triggered thereafter, with additional sampling for catheters kept for more than 14 days. Culture-confirmed catheter-associated urinary tract infection (CAUTI) and noninfectious events were prospectively recorded.</p><p><strong>Results: </strong>Among 670 eligible participants, 20 refused; 592 were analyzed (median age 51.7 years, 41% of women). Latex, silicone, and Bactiguard Infection Protection (BIP)-coated silicone catheters were used in 451, 120, and 21 insertions, respectively. Culture-confirmed CAUTI occurred in 50% of Latex, 22% of silicone, and 5% of BIP-coated silicone catheterizations (<i>P</i> < 0.0001). The overall incidence of the Centers for Disease Control and Prevention-defined symptomatic CAUTI in the study cohort was 16.7%. Versus ≤5 days, dwell >30 days markedly raised pain/discomfort (RR: 7.1, 95% confidence interval, 2.1-24), hematuria (RR: 10.6, 2.2-51) and sexual issues (RR: 21.2, 2.0-228). Regression identified dwell length (OR: 1.07 per day) and latex material (OR: 3.8) as independent CAUTI drivers. Prolonged catheterization was also associated with marked psychosocial morbidity, including social restriction and sexual dysfunction, which increased exponentially beyond 14 days.</p><p><strong>Conclusion: </strong>Complications escalate sharply after day 5 and are amplified by Latex. Replacing Latex with silicone and limiting dwell time could potentially halve the incidence of culture-confirmed CAUTI. BIP catheters appear highly protective, but demand confirmation in future, robust, multicenter trials.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 2","pages":"148-156"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}