World Journal of Urology最新文献

{"title":"Acute urinary retention in children: a systematic review and meta-analysis.","authors":"H Shafeeq Ahmed, Akhil Fravis Dias, Sneha Reddy Pulkurthi","doi":"10.1007/s00345-025-05886-w","DOIUrl":"10.1007/s00345-025-05886-w","url":null,"abstract":"<p><strong>Purpose: </strong>Acute urinary retention (AUR) in children is a rare but significant urological emergency, characterized by an inability to void despite a full bladder. Despite its clinical significance, standardized diagnostic and management protocols are lacking, and the long-term outcomes remain poorly understood. This systematic review and meta-analysis aim to synthesize data on the prevalence, risk factors, etiologies, and treatment outcomes of AUR in pediatric patients.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic literature search was conducted across PubMed, Scopus, and CINAHL Ultimate databases until January 2025. Eligible studies included pediatric AUR cases (< 18 years) with at least ten patients. Meta-analysis was performed using a random-effects model. Sensitivity analyses and funnel plots were employed to evaluate robustness and potential publication bias.</p><p><strong>Results: </strong>Eight studies (n = 611 patients) were included. The pooled prevalence of infectious causes was 26.9% (95% CI: 16.0%-39.4%), obstructive causes 19.0% (95% CI: 7.4%-34.1%), and neurological causes 6.4% (95% CI: 2.6%-11.6%). Other identified causes included post-procedural (6.9%, 95% CI: 0.8%-17.2%), bladder musculature dysfunction (3.8%, 95% CI: 0.8%-8.2%), external compression (11.1%, 95% CI: 7.6%-15.1%), and idiopathic (14.6%, 95% CI: 9.9%-20.0%). Catheterization was the primary treatment, with most requiring intervention and some resolving spontaneously. Recurrence was also observed in a few cases.</p><p><strong>Conclusion: </strong>Pediatric AUR presents a complex diagnostic challenge due to diverse etiologies and varying clinical presentations. Early recognition and targeted intervention are critical in reducing complications. Future studies should focus on standardizing diagnostic protocols and long-term follow-up to optimize management strategies for pediatric AUR.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"513"},"PeriodicalIF":2.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of concomitant holmium laser enucleation of the prostate with transurethral endoscopic management of symptomatic large bladder diverticulum: revisiting a historical technique in the modern era with literature review.","authors":"Aravindh Rathinam, Ansh Bhatia, Maggie Meyreles, Hasim Bakbak, Johnathan Katz, Robert Marcovich, Hemendra N Shah","doi":"10.1007/s00345-025-05844-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05844-6","url":null,"abstract":"<p><strong>Introduction: </strong>Acquired bladder diverticulum (BD) is typically managed using open, laparoscopic, or robotic approaches. Although transurethral techniques demonstrated favorable outcomes in the 1970s and 1980s, they have largely fallen out of favor. This study revisits transurethral endoscopic management of large, symptomatic BD, combined with Holmium laser enucleation of the prostate (HoLEP) for patients with benign prostatic obstruction (BPO) and coexisting BD.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent combined HoLEP with transurethral endoscopic management of bladder diverticulum (C-HoLEP-TUBD) between May 2017 and January 2025. Following HoLEP, the diverticular neck was circumferentially resected, and the diverticular mucosa was fulgurated using bipolar cautery. Follow-up cystography was obtained 6-12 weeks postoperatively and perioperative data were collected and analyzed.</p><p><strong>Results: </strong>Six patients (mean age: 72 + 7.46 years) underwent the procedure. The mean prostate volume was 91 ± 43 cc, and mean BD size was 8.57 ± 5.28 cm. Preoperative Qmax averaged 4.76 ml/s, and mean post-void residual (PVR) was 372.8 cc. At 3-month follow-up, Qmax improved to 25.74 ± 22.4 ml/s, and PVR decreased to 22 ± 23.24 cc. Mean diverticulum size reduced to 1.7 ± 1.19 cm, representing an of 81.89 ± 15.09% reduction. No patient had a residual diverticulum > 2 cm or developed related symptoms during follow-up.</p><p><strong>Conclusion: </strong>C-HoLEP-TUBD is a safe and effective technique for managing large, symptomatic bladder diverticula in patients with BPO. This combined approach offers significant improvements in urinary function and diverticulum size. Further multi-institutional studies are warranted to confirm these findings and evaluate long-term outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"508"},"PeriodicalIF":2.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed artificial urinary stones reproducing human morphology: a novel laboratory model for endourology test and simulation.","authors":"Federico Zorzi, Imade Koutiri, Corinne Dupuy, Stefano Moretto, Marie Chicaud, Stessy Kutchukian, Laurent Berthe, Steeve Doizi, Olivier Traxer, Frédéric Panthier","doi":"10.1007/s00345-025-05846-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05846-4","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"507"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A secreted signature discriminates indolent from aggressive prostate tumors.","authors":"Yu Wang, Yong Liu, Xiaona Lin, Kebing Wang, Haidong Wen, Chutian Xiao, Yisong Guo, Jianjie Wu, Ke Li, Zheng Chen, Yanying Ji, Gengguo Deng, Jinming Di, Xin Gao","doi":"10.1007/s00345-025-05739-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05739-6","url":null,"abstract":"<p><strong>Background: </strong>No non-invasive biomarkers are clinically available to distinguish aggressive prostate cancer (PCa) from the indolent PCa, as thus may lead the misdiagnose and overtreatment to the patients. This study aims to identify secreted proteins and assess their potentials to discriminate two PCa subtypes.</p><p><strong>Methods: </strong>Microarray assay on tissue specimens of the discovery cohort identified secreted genes associated with invasive PCa and macrophage polarization, and the results were validated in an independent cohort. As elevated expression of ΔC499 has been linked to metastatic PCa and poorer prognosis, the relationship of key secretory genes and ΔC499 was investigated. Their roles on macrophage polarization were studied in co-cultured cells, PCa mouse model and patient blood samples. Finally, a multi-gene secreted signature model was developed and tested in training and validation cohorts.</p><p><strong>Results: </strong>ITGB5 was upregulated and TIMP1/TMEM176B were downregulated at RNA level in aggressive Pca, with bioinformatics linking these changes to M2 macrophage polarization. Additionally, we found that ITGB5 expression was positively regulated while TIMP1 and TMEM176B were negatively regulated through distinct transcriptional pathways. Further, we revealed that ΔC499 contributes to ITGB5-driven M2 macrophage polarization, enhancing PCa invasion in vitro and in vivo. Lastly, a multi-gene model integrating ITGB5, TIMP1, and TMEM176B distinguished indolent from aggressive PCa in training cohort (AUC = 0.88) and validation cohort (AUC = 0.90).</p><p><strong>Conclusion: </strong>ΔC499 induces M2 macrophage polarization and drives PCa invasiveness by modulating ITGB5, TIMP1, and TMEM176B. Three genes signature is differentially expressed between aggressive and indolent tumors, providing potential non-invasive biomarkers to discriminate aggressive from indolent PCa.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"506"},"PeriodicalIF":2.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of prostate health index (PHI) in prostate cancer screening: cost minimization analysis through simulation modelling.","authors":"Leire Rius Bilbao, Urko Aguirre Larracoechea, Carmen Valladares Gomez, Javier Mar, Carmen Mar Medina","doi":"10.1007/s00345-025-05606-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05606-4","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is the most frequently diagnosed cancer globally, with rising incidence rates, particularly in Europe. Prostate specific antigen (PSA) testing, often leads to overdiagnosis and unnecessary biopsies. This study aims to assess the cost-saving potential of incorporating the Prostate Health Index (PHI) as a biomarker in PCa screening programmes to reduce unnecessary biopsies and optimize costs in healthcare systems.</p><p><strong>Methods: </strong>A simulation model was constructed using data from an observational study in a clinical setting. PHI values were used to determine biopsy decisions in a simulated population of 10,000 men aged 50-70 with PSA levels 3-10 ng/mL. Logistic regression modeled the correlation between PHI and clinically significant PCa (csPCa). Three csPCa prevalence scenarios (10%, 20%, and 30%) were tested to assess cost-minimizing effects. Decision trees compared the PHI-guided biopsy approach to the conventional PSA-based strategy.</p><p><strong>Results: </strong>The PHI-guided approach reduced up to 49.7% negative and low-grade biopsies and demonstrated cost savings compared to the conventional PSA-based strategy. Use of PHI resulted in cost savings of €233 per patient in csPCa detection. The mean cost of the PHI pathway was €681, compared to €915 for the conventional PSA-based pathway. However, the study's reliance on synthetic data and the limited inclusion of MRI in the dataset may affect the generalizability of findings.</p><p><strong>Conclusions: </strong>Incorporating PHI into PCa screening could reduce overdiagnosis, unnecessary biopsies, and overall healthcare costs. Further prospective studies are needed to confirm PHI's role as a cost-effective reflex test and its integration into broader PCa screening strategies.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"504"},"PeriodicalIF":2.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of human papillomavirus in male genital samples.","authors":"Saúl A Villasmil, Jorgen A Marcano, José A Briceño, Alejandro Rísquez, Militza Quintero, John Cruz, Miriam Y Villasmil, Leonardo Acosta, Luis Duarte, César El Kadi","doi":"10.1007/s00345-025-05873-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05873-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study focuses on the detection of human papillomavirus (HPV) in genital samples from heterosexual men, with or without HPV-like lesions, using molecular biology techniques for diagnosis and genotyping of the virus.</p><p><strong>Method: </strong>A retrospective observational study was conducted with 294 male patients who visited a laboratory for molecular testing, with a presumptive clinical-epidemiological diagnosis of HPV infection, without prior HPV disease or vaccination. Samples were analyzed using Polymerase Chain Reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP) techniques.</p><p><strong>Results: </strong>Detection of HPV-infected men was 50.8%, with significant variability in incidence depending on the anatomical site of sampling. Fourteen high-risk HPV types were identified, along with the presence of multiple subtypes in several patients.</p><p><strong>Conclusion: </strong>This study provides valuable insights into HPV incidence in men, the most prevalent genotypes, and their correlation with lesion presence. These findings may aid in developing prevention, vaccination, and control strategies for HPV in men.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"505"},"PeriodicalIF":2.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waiting for HoLEP-outcomes when complications arise in the preoperative period.","authors":"Clarissa Wong, Perry Xu, Meera Ganesh, Nabila Reem Khondakar, Luis Gago, Dimitri Speron, Kyle Tsai, Alyssa McDonald, Allaa Fadl-Alla, Nicholas Dean, Amy Krambeck","doi":"10.1007/s00345-025-05871-3","DOIUrl":"10.1007/s00345-025-05871-3","url":null,"abstract":"<p><strong>Purpose: </strong>Surgery for benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP), is often considered to be elective, leading to many patients waiting for intervention. Wait times for HoLEP can vary on many factors, but the incidence and impact of complications in this preoperative waiting period are unknown. We sought to uncover the outcomes of HoLEP in patients who experienced a complication while waiting for surgery.</p><p><strong>Methods: </strong>We performed a retrospective review of a prospectively maintained database of patients who underwent HoLEP at a high-volume center between January 2021 and August 2023. Date of surgical case request placement, date of complication occurrence, and date of HoLEP were recorded. Preoperative, intraoperative, and postoperative characteristics were collected and analyzed. Statistical analysis was performed with SPSS software with p < 0.05 denoting significance.</p><p><strong>Results: </strong>We identified 918 patients in the database in this timeframe, with 74 experiencing a complication while waiting for HoLEP. Mean preoperative prostate volume was 122.7 ml. Complications included 8 cardiac and 37 urologic events. Complications were associated with a 31.2-day increase in wait time. Patients with cardiac complications waited 113.5 days (p = 0.013). Patients who had a complication while waiting were more likely to be on benign prostatic hyperplasia (BPH) medications, be catheter dependent, and have urinary tract infections (UTI) within 6 months of surgery. The 90-day postoperative complication rate was 31.5% in the complication group and 20.4% in the non-complication group. Patients who experienced a wait time complication were also more likely to have prolonged postoperative catheter duration and increased emergency room visits.</p><p><strong>Conclusion: </strong>Patients with history of UTI and catheter dependence are more likely to experience a complication while waiting for HoLEP. Having a wait time complication can significantly delay surgery date by up to 30 days, and patients experiencing complication preoperatively are more likely to experience further complications postoperatively. Efforts are needed to expedite and improve access to necessary BPH procedures.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"499"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding \"Retrospective, single center evaluation of transperineal prostate biopsy omitting antibiotic prophylaxis and omitting periinterventional screening for bacteriuria\".","authors":"Ajay Guru, Rupesh Gupta","doi":"10.1007/s00345-025-05859-z","DOIUrl":"10.1007/s00345-025-05859-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"497"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: global perspectives on the variability of antibiotic prophylaxis practices in holep and AI-assisted optimization strategies.","authors":"Zhiyu Shi, SiNan Yang, Chengwei Bi, Yong Yang","doi":"10.1007/s00345-025-05867-z","DOIUrl":"10.1007/s00345-025-05867-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"496"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saturation effect between operation time and post-PCNL SIRS in pediatric patients.","authors":"Nueraili Abudurexiti, Xun Li, Bide Liu, Shuheng Wang, Qiang Dong","doi":"10.1007/s00345-025-05869-x","DOIUrl":"10.1007/s00345-025-05869-x","url":null,"abstract":"<p><strong>Background: </strong>Prolonged operation time has been associated with an increased incidence of postoperative complications in various surgical procedures. However, its role in pediatric percutaneous nephrolithotomy (PCNL) remains unclear. This study aimed to investigate the relationship between operation time and systemic inflammatory response syndrome (SIRS) incidence in pediatric patients undergoing PCNL.</p><p><strong>Methods: </strong>This retrospective study included 472 pediatric patients who underwent PCNL, the primary exposure of interest was operation time, while the primary outcome was the incidence of postoperative SIRS. Multivariate logistic regression, restricted cubic spline (RCS) analysis, and two-piecewise linear regression models were used to assess the relationship and potential threshold effects between operation time and postoperative SIRS. Subgroup analyses were used to investigate the association across different subgroups.</p><p><strong>Results: </strong>The median age of the patients was 7 years (interquartile range: 3-12), and 56.36% were male. The median operation time was 80 min (interquartile range: 70-95). Postoperatively, 90 patients developed SIRS, accounting for 19.07% of the total cohort. In the fully adjusted model, compared with the low operation time group, the adjusted odds ratios (95% confidence intervals) for postoperative SIRS were 2.63 (1.20, 5.83) for the medium operation time group and 2.86 (1.28, 6.54) for the high operation time group, respectively. RCS with threshold effect analysis revealed a saturation effect between operation time and postoperative SIRS, with a threshold identified at 70 min. Subgroup analyses indicated that underweight pediatric patients are more susceptible to the effects of operation time.</p><p><strong>Conclusion: </strong>Prolonged operation time in pediatric patients undergoing PCNL is an independent risk factor for postoperative SIRS, with a non-linear saturation effect relationship and a threshold effect. These findings may contribute to the optimization of surgical strategies for pediatric PCNL aimed at reducing postoperative SIRS.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"498"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}