World Journal of Urology最新文献

{"title":"Validation of Stockholm3 for prostate cancer detection in a swiss non-referral cohort: balancing biopsy reduction and diagnostic performance.","authors":"Jonas Mudlagk, Odile Minder, Ashkan Mortezavi, Benjamin Bulling, Julian Cornelius, Nicolas Arnold, Beat Roth, Livio Mordasini, Nicola Giudici","doi":"10.1007/s00345-026-06377-2","DOIUrl":"https://doi.org/10.1007/s00345-026-06377-2","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate cancer (PCa) diagnosis relies on PSA testing, but its low specificity leads to overdiagnosis. Stockholm3 may improve diagnostic accuracy. This study evaluated the performance of Stockholm3 for detecting clinically significant PCa (csPCa), defined as ISUP grade ≥ 2 on biopsy, in a real-world, non-referral Swiss cohort.</p><p><strong>Methods: </strong>Retrospective analysis of a prospective registry (2023-2025) at a non-referral urology practice in Switzerland. Initial screening was performed in men with PSA > 1.5 ng/mL or a suspicious digital rectal examination. Patients who underwent Stockholm3 and biopsy were included. We compared Stockholm3 with PSA, PSA density, and the SWOP risk calculator for the detection of csPCa in a pre-MRI diagnostic setting.</p><p><strong>Results: </strong>We included 178 men (median age 65 years, IQR: 60.0-70.0). Among them, 60/178 (33.7%) had csPCa. Stockholm3 ≥ 15 showed sensitivity 0.78 (95% CI 0.67-0.88), specificity 0.44 (95% CI 0.35-0.54), and AUC 0.68 (95% CI 0.60-0.77). SWOP score > 4% showed sensitivity 0.42 (95% CI 0.30-0.55), specificity 0.78 (95% CI 0.70-0.85), and AUC 0.68 (95% CI 0.59-0.76). Both tests outperformed PSA > 3 ng/mL and PSA density > 0.15 ng/mL², with AUCs of 0.52 (95% CI 0.48-0.56) and 0.57 (95% CI 0.50-0.64), respectively. Decision curve analysis and calibration curves favored Stockholm3 over SWOP.</p><p><strong>Conclusions: </strong>In a non-referral setting, Stockholm3 confirmed good diagnostic performance for csPCa. These findings support its use as part of the primary diagnostic work-up in similar clinical settings.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515309","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":"Real-world persistence of vibegron in patients aged ≥ 80 years with overactive bladder: a multicenter cohort study.","authors":"Taro Igarashi, Yuto Nukariya, Shota Kawano, Mimu Ishikawa, Fumihiko Urabe, Masaya Murakami, Shunsuke Tsuzuki, Mariko Honda, Yusuke Koike, Takehito Naruoka, Takahiro Kimura, Akira Furuta","doi":"10.1007/s00345-026-06365-6","DOIUrl":"https://doi.org/10.1007/s00345-026-06365-6","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence on real-world persistence of β3-adrenoceptor agonists in patients aged ≥ 80 years with overactive bladder (OAB) is limited. We evaluated vibegron persistence and examined whether polypharmacy, anticholinergic cognitive burden (ACB), and prior anticholinergic exposure were associated with time to treatment discontinuation.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter cohort study across nine urology outpatient departments in Japan (2018-2023). Vibegron-naïve patients aged ≥ 80 years were included, and those with missing key covariates were excluded. The primary analysis compared time to discontinuation between patients taking 1-5 versus ≥ 6 concomitant medications using 1:1 propensity score matching (PSM). Secondary PSM analyses assessed ACB category (0-1 vs. ≥ 2) and prior anticholinergic exposure (yes vs. no). Persistence was evaluated using Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>Among 889 eligible patients, 838 comprised the complete-case cohort (median age, 83 years; 31.3% female). In the polypharmacy-matched cohort (212 pairs), polypharmacy was associated with shorter persistence (log-rank P = 0.044) and a higher risk of discontinuation (hazard ratio, 1.32; 95% confidence interval, 1.01-1.73). In secondary analyses, persistence did not differ by ACB category (191 pairs; log-rank P = 0.356) or by prior anticholinergic exposure (166 pairs; log-rank P = 0.656).</p><p><strong>Conclusions: </strong>In patients aged ≥ 80 years initiating vibegron, polypharmacy was associated with shorter treatment persistence after matching, whereas ACB and prior anticholinergic exposure were not. These findings suggest that overall medication burden and care-related factors, rather than anticholinergic burden alone, may influence long-term persistence of OAB therapy in super-elderly patients.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515277","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":"Efficacy and safety of 6.3-Fr versus 8.6-Fr disposable digital flexible ureteroscopes for pediatric upper urinary tract stones ≤ 2 cm: a randomized controlled trial.","authors":"Qibo Hu, Hongbo Liu, Chunxiao Lin, Wei Ru, Zheming Xu, Lizhe Hu, Zihao Xu, Kangjie He, Lexin Liu, Xiang Yan","doi":"10.1007/s00345-026-06352-x","DOIUrl":"https://doi.org/10.1007/s00345-026-06352-x","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515176","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":"Influence of concomitant distant lymph node metastases in metastatic hormone-sensitive prostate cancer patients with bone metastases.","authors":"Mike Wenzel, Benedikt Lauer, Vincenzo Giuseppe Mühlthaler, Maximilian Filzmayer, Carolin Siech, Chi Le, Clara Humke, Marina Kosiba, Maximilian Kriegmair, Thomas Steuber, Felix K H Chun, Philipp Mandel","doi":"10.1007/s00345-026-06358-5","DOIUrl":"10.1007/s00345-026-06358-5","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13013245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515242","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":"Challenging recurrent ureteropelvic junction obstructions: endoscopic procedures versus redo-pyeloplasty-a systematic review and meta-analysis.","authors":"Michael E Chua, Marilyn M Wong, Mikael Gouwtama, Jessica M Ming, Jin Kyu Kim, Mandy Rickard, Rodrigo Romao, Pippi Salle, Jessie Cunningham, Joana Dos Santos, Armando J Lorenzo","doi":"10.1007/s00345-026-06339-8","DOIUrl":"https://doi.org/10.1007/s00345-026-06339-8","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504878","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":"Complications and symptom burden of ureteral double-J stents: a systematic review of prevalence, risk factors, and management strategies.","authors":"Yuan Wen Ooi, Arianna Pischetola, Selcuk Guven, Theodoros Tokas, Vineet Gauhar, Steffi Kar Kei Yuen, Bhaskar K Somani","doi":"10.1007/s00345-026-06299-z","DOIUrl":"https://doi.org/10.1007/s00345-026-06299-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504981","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":"Hirschsprung disease and associated urological morbidities: institutional experience and systemic review.","authors":"Quang Thanh Nguyen, Hien Duy Pham, Dung Boi Ly, Trang Thu Dang, Hanh Thi My Do, Nhung Thi Nguyen, Quynh Anh Tran","doi":"10.1007/s00345-026-06209-3","DOIUrl":"10.1007/s00345-026-06209-3","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500034","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":"Experience of 5 years adjustable continence therapy (ProACT): the surgical learning curve and patient outcomes.","authors":"Lisa M de Zeeuw, Coen H H Christiaans, Sebastiaan Remmers, Bertil F M Blok, Alexander B Stillebroer","doi":"10.1007/s00345-026-06291-7","DOIUrl":"10.1007/s00345-026-06291-7","url":null,"abstract":"<p><strong>Purpose: </strong>Post-prostatectomy urinary incontinence (PPI) significantly impacts quality of life. While an artificial urinary sphincter is the standard surgical treatment for PPI, adjustable continence therapy balloons (ProACT) have emerged as a less invasive alternative over the past two decades. ProACT implantation is considered technically challenging and limited to three high-volume Dutch medical centers, yet little is known about the surgical learning curve. This study aims to assess the learning curve to inform training requirements for ProACT implantation.</p><p><strong>Methods: </strong>This retrospective single-center study included all ProACT implantations performed by one urologist at Erasmus University medical Center, Rotterdam. Surgery success was defined as postoperative use of a maximum of one 'safety pad', less than 10 mL urine loss or ≥ 95% subjective improvement of continence. Multivariable logistic regression assessed the learning curve.</p><p><strong>Results: </strong>A total of 108 surgeries between 2019 and 2024 were included, of which 15 were supervised by an experienced surgeon. No statistical relation was found between the progressive surgeon's experience and surgical success (per 10 surgeries, OR 0.89, 95%CI: 0.75-1.07, p = 0.2). Preoperative incontinence (pads/day) was statistically significantly associated with surgical success (OR 0.65, 95%CI: 0.47-0.89, p = 0.009). The overall surgical success rate was 61%, with an additional 20% achieving > 50% continence improvement. Complication rate within six months was 21% of which six (5.6%) included explantations of the ProACT device.</p><p><strong>Conclusion: </strong>ProACT implantation achieves consistent outcomes after brief supervised training, with no statistically significant learning curve. This supports a broader adoption of this technique by urologists treating PPI.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500009","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":"Ejaculation-preserving holmium laser enucleation of the prostate: a systematic review of techniques, functional outcomes, and safety.","authors":"Mehmet Hamza Gultekin, Kadir Can Sahin, Admir Ozturk, Feyyaz Irmak, Bulent Onal","doi":"10.1007/s00345-026-06348-7","DOIUrl":"10.1007/s00345-026-06348-7","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494453","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":"Peritoneal interposition flaps in robot-assisted radical prostatectomy with pelvic lymph node dissection: from efficacy to optimization.","authors":"Matthias May, Anton Kravchuk, Martin Burchardt, Ingmar Wolff","doi":"10.1007/s00345-026-06366-5","DOIUrl":"https://doi.org/10.1007/s00345-026-06366-5","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491930","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}