World Journal of Urology最新文献

{"title":"Grip strength, a predictor of stress urinary incontinence after endoscopic enucleation of the prostate for benign prostate hyperplasia.","authors":"Hong-Chen Song, Meng-Hua Wu, Dong Han, Jia-Xin Liu, Zi-Bing Cao, Yuan Du, Ming-Jun Shi, Jian Song, Xuan-Hao Li","doi":"10.1007/s00345-024-05431-1","DOIUrl":"https://doi.org/10.1007/s00345-024-05431-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the grip strength (GS) and stress urinary incontinence (SUI) after endoscopic enucleation of the prostate (EEP).</p><p><strong>Methods: </strong>We retrospectively collected 87 patients who underwent EEP at our center from January to December 2023. The associations between GS and post-surgical SUI at immediate, 1, 4, 12 and 24 weeks were analyzed. The cohort was then divided into the SUI and non-SUI group based on the presence of the SUI at 4-week postoperatively.</p><p><strong>Results: </strong>Of overall 87 patients, 49 (56.3%), 40 (46.0%), 33 (37.9%), 20 (23.0%), and 9 (10.3%) patients presented SUI at immediate, 1, 4, 12 and 24 weeks postoperatively. Significant negative correlations were consistently observed between the GS and SUI till 12 weeks postoperatively, with patients requiring more daily pads presenting lower GS. Compared to the non-SUI group, the SUI group had significantly higher average age (76.0 ± 8.4 vs. 70.1 ± 6.3, P = 0.001), BMI (25.1 ± 2.9 vs. 23.8 ± 2.9, P = 0.040), rates of PKEP (90.9% vs. 72.2%, P = 0.037), CSEA (69.7% vs. 42.6%, P = 0.014) and III/IV ASA score (33.3% vs. 14.8%, P = 0.043), but lower GS (26.2 ± 8.2 vs. 33.3 ± 6.5 kg, P < 0.001). Multivariate analyses identified BMI and GS as independent risk factors for post-operative SUI.</p><p><strong>Conclusions: </strong>The GS was found to be negatively correlated with post-operative SUI within 12 weeks after EEP and was an independent predictor of SUI at 4 weeks postoperatively.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"80"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012946","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":"Tunica vaginalis or dartos as second layer coverage for distal and mid-shaft penile hypospadias, quo vadis?","authors":"Mohamed Ramez, Abdelwahab Hashem, Mahmoud Bazeed, Mohamed S Dawaba, Tamer E Helmy","doi":"10.1007/s00345-024-05419-x","DOIUrl":"10.1007/s00345-024-05419-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare between the dartos and tunica vaginalis flaps as covering layers in denovo distal or mid-shaft penile hypospadias underwent tubularized incised plate (TIP) repair.</p><p><strong>Methods: </strong>This is a single-center, randomized trial was for denovo distal or mid-shaft penile hypospadias. Children with history of orchiectomy, orchiopexy and inguinal hernia repair were excluded. Eighty-eight patients were divided into two groups: the first used dartos flap (DF), while the second used tunica vaginalis flap (TVF). The primary outcome was to assess the incidence of urethrocutaneous fistula. The secondary outcome was to assess cosmetic outcome using paediatric penile perception score (PPPS) and hypospadias objective scoring evaluation (HOSE).</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics showed no statistically significant. Median operative time (IQR) was 100 (90, 120) and 145 (140, 150) minutes in in DF and TVF Groups, respectively (p < 0.001). Urethrocutaneous Fistula was detected in 9 (20.9%) in DF group and 2 (4.9%) in TVF group (p 0.029). Meatal stenosis occurred in 3 (7%) in DF group and 2 (4.9%) in TVF group. Penile torque was diagnosed in one (2.4%) in TVF group. There was no significant difference in total PPPS score (p = 0.076), however, there was a significant difference in total HOSE score in the favour to TVF group (p = 0.024). At 12 months, testicular ascent occurred in 0% and 3 (7.3%) in DF and TVF groups, respectively (p = 0.071).</p><p><strong>Conclusion: </strong>Compared to dartos flap, tunica vaginalis flap significantly helps in reduction of fistula rate. However, it has significant more operative time.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"78"},"PeriodicalIF":2.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012873","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":"Real time monitoring of intrarenal pressures while using the flexible and navigable suction ureteral access sheath.","authors":"Kelven Weijing Chen, Kyo Chul Koo, Tianshuang Zhong, Runhan Ren, Victor Kf Wong, Saud Almousa, Max Levitt, Abbas Guennoun, Ben H Chew, Naeem Bhojani","doi":"10.1007/s00345-025-05444-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05444-4","url":null,"abstract":"<p><strong>Purpose: </strong>To report on in-vivo intrarenal pressure (IRP) during flexible ureteroscopy for treatment of kidney stones while using the novel flexible and navigable suction ureteral access sheath (FANS).</p><p><strong>Methods: </strong>A retrospective observational analysis was performed for 25 patients undergoing routine flexible ureteroscopy for treatment of renal stones between February 2024 and June 2024 from two centres in Canada. The LithoVue Elite™ ureteroscope (Boston Scientific Corp., Marlborough, MA, USA) with pressure sensing capability was used together with the Clearpetra^® Ureteral Access Sheath System (Well Lead Medical Co. Ltd., Guangzhou, China) for all cases. Irrigation was via a pressure bag set at 250mmHg where possible and the access sheath was connected to wall suction at 200mmHg. Median and maximum IRP, as well as the distribution of cumulative procedure times according to various IRP ranges were analyzed.</p><p><strong>Results: </strong>The median age of the patients was 56 years, with a median BMI of 26.7 kg/m². The median (Interquartile range {IQR}) IRP for all the cases was 22.0 (15.0-36.5) mmHg, with a median (IQR) procedure time of 35.9 (16.4-54.8) minutes. The IRP remained below 40mmHg in 76.2% of the total time in all procedures, and was below 60mmHg in 94.1% of the time. Significant variables associated with lower IRP were having a prior endourological procedure, pre-stenting, larger ureteral access sheath size and use of pre-operative alpha blocker. Age, BMI and total stone volume did not significantly affect IRP.</p><p><strong>Conclusions: </strong>Low intrarenal pressures can be achieved with the use of FANS, even with higher irrigation pressures. Alpha blocker use, larger sheath size, prior endourological procedures and pre-stenting are all associated with lower IRP.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"76"},"PeriodicalIF":2.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012871","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 of urethral suspension-assisted urethral anastomosis as a treatment for complex long-segment posterior urethral stricture.","authors":"Ying Wang, Meng Liu, Chongrui Jin, Lujie Song, Ranxing Yang, Qiang Fu","doi":"10.1007/s00345-025-05442-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05442-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.</p><p><strong>Materials and methods: </strong>The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile-scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o'clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.</p><p><strong>Results: </strong>The mean patient age was 46.7 years (range 27-64) and the median urethral stricture length was 5.1 cm. The urethral catheter was removed 4 weeks postoperatively. The median follow-up duration was 13.6 months (4-32). Urinary flow remained unobstructed in 22 patients (91.7%), with an average maximum flow rate of 24.5 ml/s (15.3-36.2). Urethral stricture recurred post-surgery in two patients, one of whom underwent successful repair with the same surgical procedure while the other achieved successful voiding after urethrotomy.</p><p><strong>Conclusions: </strong>Urethral suspension-assisted urethral anastomosis is an effective treatment for complex long-segment posterior urethral stricture. This technique allows for optimal exposure of the proximal urethral mucosa, reduces the distance between the proximal and distal urethra, simplifies surgical procedures, enables tension-free anastomosis between the proximal and distal urethra, and has a high success rate.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"77"},"PeriodicalIF":2.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012944","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":"Comparative study of HoLEP in elderly patients with indwelling catheters: a retrospective dual-center study.","authors":"Clément Klein, Julien Anract, Ugo Pinar, Xavier Lacroix, Raymond Mansour, Grégoire Robert, Nicolas Barry Delongchamps","doi":"10.1007/s00345-024-05437-9","DOIUrl":"https://doi.org/10.1007/s00345-024-05437-9","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the safety and efficacy of HoLEP in patients aged > 85 years with indwelling catheter (IDC).</p><p><strong>Methods: </strong>We retrospectively analyzed our bicentric HoLEP database to identify consecutive patients with IDC and trial without catheter (TWOC) failure who underwent surgery between June 2012 and April 2020. Our primary focus was on the population over 85 years of age; Patients under 70 years of age were used as controls. We evaluated the rate of postoperative spontaneous micturition, adverse events and mortality, as well as catheterization duration, hospital stay, and rate of urinary incontinence.</p><p><strong>Results: </strong>In total, 144 patients were included, with 71 (49.3%) and 73 (50.8%) in the ≥ 85 and control group, respectively. The median [IQR] prostatic volume and Charlson score was 90 [70-130] vs. 90 [65-120] mL and 6 [5-7] vs. 3 [2-4] in the ≥ 85 and control groups, respectively. Postoperatively, the rates of major complications (2% vs. 3%) and transfusion (11% vs. 9%) were not significantly different. The median length of stay (2 [1-3] vs. 1 [1-2]; p = 0.03) and rate of TWOC failure during hospitalization (24% vs. 5%, p < 0.001) were significantly higher in the ≥ 85 group. At 3 months and one year follow-up visits, 0 and 10 patients (14.1%) in the ≥ 85 group and 0 and 2 patients (3%) in the control group died, respectively. One year after surgery, 69 (97%) and 73 (100%) (p = 0.2) patients in the ≥ 85 and control groups, respectively, could void spontaneously.</p><p><strong>Conclusion: </strong>HoLEP is a safe and effective procedure for elderly patients with indwelling catheters. At one year, 97% of patients achieved spontaneous voiding, while the urinary incontinence rate was 11%. The 1-year mortality rate was 14%, comparable to that of the general male population of the same age.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"75"},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012942","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 multicenter study of perioperative and functional outcomes of open vs. robot assisted uretero-enteric reimplantation after radical cystectomy.","authors":"Tarek Ajami, Mireia Musquera, Joan Palou, Khurshid A Guru, Ahmed Aly Hussein, Daniel Eun, Abolfazl Hosseini, Josep Maria Gaya, Ronney Abaza, Umar Iqbal, Randall Lee, Ziho Lee, Matthew Lee, Carles Raventos, Alberto Breda, Fernando Lozano, Enrique Trilla, Francesc Vigués, Albert Carrion","doi":"10.1007/s00345-024-05435-x","DOIUrl":"https://doi.org/10.1007/s00345-024-05435-x","url":null,"abstract":"<p><strong>Introduction: </strong>Open ureteroenteric reimplantation (OUER) of ureteroenteric strictures (UESs) is related to important morbidity. Robot-assisted ureteroenteric reimplantation (RUER) has been proposed to provide similar outcomes with lower morbidity. We aimed to compare perioperative and functional outcomes between RUER and OUER.</p><p><strong>Methods: </strong>A retrospective multicenter study of 80 patients, who underwent 82 ureteroenteric reimplantations (17 OUER vs 65 RUER) at 8 institutions between 2009-2021 for benign UESs after radical cystectomy. All the open procedures were performed by the same center in order to compare the robotic approach with a standardized technique. Data were reviewed for demographics, stricture characteristics, and perioperative outcomes. Complication and stricture recurrence rates were compared between both groups.</p><p><strong>Results: </strong>Among 82 reimplantations, 44 were left sided (54%) and 12 bilateral (14%). Median time from cystectomy to diagnosis of stricture was 6 months (range 3-18). Baseline characteristics (gender, age, BMI, side, type of urinary diversion and previous abdominal radiotherapy) were comparable between RUER and OUER groups, except for ASA score and rates of prior robotic cystectomy. The 30-day overall postoperative complication rate was 37% in RUER compared to 70.6% in OUER (p = 0.026). Patients who underwent a RUER had statistically significant lower rate of intraoperative blood transfusion (0% vs 12%, p = 0.041), urinary tract infection (12% vs 53%, p < 0.001), bowel injury (0% vs 12%, p = 0.041) and high-grade complications (Clavien III-IV) (4.6% vs 23.5%, p = 0.031). RUER patients had shorter median length of hospital stay (3 days IQR[1-6] vs 6 IQR[3-9], p = 0.018) and lower readmission rate (4.6% vs 29.4%, p = 0.008). After a median follow-up of 23.5 months (8.7-43), 80% of RUER cases were stricture free compared to 90% of OUER (p = 0.42).</p><p><strong>Conclusions: </strong>RUER achieved a success rate comparable to that of open revisions and may provide some advantages in terms of perioperative outcomes. Prospective and larger studies are warranted to prove its superiority compared to the standard open technique.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"74"},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012934","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":"Research progress on intratumoral microorganisms in renal cancer.","authors":"Jiankun Zhang, Keyuan Lou, Junpeng Chi, Jitao Wu, Xinying Fan, Yuanshan Cui","doi":"10.1007/s00345-024-05403-5","DOIUrl":"https://doi.org/10.1007/s00345-024-05403-5","url":null,"abstract":"<p><p>The human body harbors a vast array of microorganisms. Changes in the microbial ecosystem can potentially lead to diseases, including cancer. Traditionally, research has focused more on the gut microbiota and its influence on cancer. However, with the advancement of sequencing technologies, scholars have discovered that microorganisms within kidney tissues are significant components of tumor tissues. Intratumoral microorganisms may affect tumor growth and development through certain mechanisms, influence the function of immune cells, or impact the effectiveness of chemotherapy or immunotherapy in patients. This paper reviews the latest progress in the research on intratumoral microorganisms in renal cancer (RCa). It summarizes the types and distribution characteristics of these microorganisms, discusses the close association between specific viral infections (such as HPV and EBV) and RCa, and highlights the role of microorganisms in the pathogenesis of RCa. This review provides new perspectives for understanding the pathogenic mechanisms of RCa, thereby offering potential clinical applications.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"72"},"PeriodicalIF":2.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984662","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":"The impact of kidney disease on peri-operative outcomes of novel BPH surgeries across the board: a propensity score matched analysis using the ACS-NSQIP database.","authors":"Oussama G Nasrallah, Maya T Herrera, Nassib F Abou Heidar, Jana H Mahdi, Rami W Nasr","doi":"10.1007/s00345-024-05430-2","DOIUrl":"https://doi.org/10.1007/s00345-024-05430-2","url":null,"abstract":"<p><strong>Background: </strong>Pre-operative kidney disease was shown to impact peri-operative outcomes of endoscopic BPH surgeries. We aim to assess the effect of novel surgical techniques (Laser Enucleation of the Prostate (LEP) and Laser Vaporization of the Prostate (LVP)) compared to Transurethral Resection of Prostate (TURP), on post-operative outcomes stratified based on kidney function.</p><p><strong>Methods: </strong>The ACS-NSQIP database was reviewed from 2008 to 2021 for 83,020 patients that underwent TURP, LEP, and LVP. Pre-operative variables were compared across kidney function groups: G1(normal/high function); G2-G3(mild/moderate kidney disease); and G4-G5(severe kidney disease). Multivariate logistic regression was performed on 30-day peri-operative complications adjusting for pre-operative variables. Propensity score matching was done between LEP and LVP to TURP.</p><p><strong>Results: </strong>LEP showed a protective effect against UTIs (p < 0.05) in the G1 and G2-G3 categories but lost that protective effect in the G4-G5 category when compared to TURP. It had longer operative time (p < 0.05) across all kidney function groups, and demonstrated shorter hospital stay (p < 0.05) in the G1 and G2-G3 categories compared to TURP. LVP had a persistent protective effect against bleeding (p < 0.05) across all kidney function groups and shorter hospital stay (p < 0.05) when compared to TURP. LVP had a protective effect against return to OR (p < 0.05) in the G1 and G2-G3 kidney function group but lost that protective effect in the G4-G5 category. LVP had significant protective effect against thromboembolic events (p < 0.05) in the G2-G3 category and against cardiac complications (p < 0.05) in the G4-G5 category.</p><p><strong>Conclusion: </strong>LEP and LVP are superior to TURP in terms of post-operative complications. The type of endoscopic surgery technique should be tailored according to patient's pre-operative kidney status and risk.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"73"},"PeriodicalIF":2.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012872","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":"Clinical outcome of BCG treatment for patients with urothelial carcinoma of the prostatic urethra: Implications for early cystectomy.","authors":"Ryo Yamashita, Takashi Sugino, Akifumi Notsu, Kana Ito, Yuma Sakura, Hideo Shinsaka, Masato Matsuzaki, Masashi Niwakawa, Eiji Kikuchi","doi":"10.1007/s00345-024-05436-w","DOIUrl":"https://doi.org/10.1007/s00345-024-05436-w","url":null,"abstract":"<p><strong>Purposes: </strong>This study aimed to clarify the clinical outcomes of Bacillus Calmette-Guérin (BCG) treatment in patients with urothelial carcinoma (UC) of the prostatic urethra.</p><p><strong>Methods: </strong>Between August 2003 and January 2023, 428 patients with non-muscle-invasive UC received BCG treatment (Tokyo strain, 80 mg, ≥ 5 times) in our hospital; 39 had UC of the prostatic urethra. We evaluated the cumulative incidence of intravesical recurrence, progression (muscle-invasive bladder cancer [MIBC] or metastasis), and subsequent radical cystectomy after BCG treatment in patients with UC of the prostatic urethra.</p><p><strong>Results: </strong>The median follow-up period was 57 months (interquartile range, 30-85 months). The exact T stage of the patients with UC of the prostatic urethra was carcinoma in situ (CIS) in 29 (27 in the prostatic urethral mucosa and two in the ductal spread), Ta in 7, Ta + CIS in 2, and T1 in 1. All 39 patients had previous or concurrent bladder cancer. Patients with UC of the prostatic urethra experienced significantly higher rates of intravesical recurrence, progression (MIBC or metastasis), and subsequent radical cystectomy than those without UC of the prostatic urethra. In the multivariate analysis, UC of the prostatic urethra was a significant risk factor for progression (hazard ratio 4.06, 95% confidence interval 1.86-8.86, p < 0.001).</p><p><strong>Conclusions: </strong>This study reported the largest number of clinical outcomes after BCG treatment in patients with UC of the prostatic urethra. Concomitant UC of the prostatic urethra is a strong predictor of subsequent progression; therefore, early timing of radical cystectomy should be discussed.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"71"},"PeriodicalIF":2.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979569","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":"Water vapor thermal therapy for treatment of lower urinary tract symptoms due to large benign prostatic hyperplasia (≥ 80 g).","authors":"Christopher Agüero, Thibaut Long Depaquit, Alessandro Uleri, William Berchiche, Renaud Corral, Arthur Peyrottes, Cyrille Bastide, Marc Fourmarier, Michael Baboudjian","doi":"10.1007/s00345-024-05433-z","DOIUrl":"https://doi.org/10.1007/s00345-024-05433-z","url":null,"abstract":"<p><strong>Introduction: </strong>Water vapor thermal therapy (WVTT; REZUM™; Boston, USA) offers symptom relief with reduced risks of complications in patients with lower urinary tract symptoms (LUTS) related to benign prostatic obstruction (BPO). WVTT therapy has been validated in the pivotal study in men with smaller prostates (< 80 cc). Yet, its feasibility for larger prostates (≥ 80 cc) remains underexplored.</p><p><strong>Methods: </strong>This retrospective study assessed WVTT efficacy and safety in 131 patients with symptomatic BPH treated between January 2022 and March 2024. Patients were categorized based on prostate size: smaller prostates (SP) (< 80 cc) and larger prostates (LP) (≥ 80 cc). Baseline characteristics, treatment specifics, and post-procedure outcomes-including retreatment rates, symptom scores, and adverse events (AEs)-were recorded. All patients who required surgical retreatment underwent Holmium laser enucleation of the prostate (HoLEP). Statistical analyses compared results between groups over 6- and 12-month follow-up periods.</p><p><strong>Results: </strong>Among the 131 patients, 48 (37%) had LP, with a median volume of 93 cc (Interquartile range (IQR) 88-110). Patients with LP experienced more non-serious AEs, primarily hematuria (p = 0.001), although serious AEs were similar across groups and limited to urinary retention (p = 0.35). At 6 months postoperatively, LP patients had a higher PVR (42 mL(IQR 21-75) vs. 21 mL (IQR2-40); p = 0.032), though this resolved by 12 months. No significant differences were observed between the groups in IPSS, maximum flow rate (Qmax), or erectile function (IIEF-5) scores at either follow-up point. Medical retreatment rates at 12 months were similar (LP: 4% vs. SP: 7%; p = 0.39), as were surgical retreatment rates (LP: 2% vs. SP: 2%; p = 0.51). Ejaculatory function was largely preserved in both groups (LP: 96%, SP: 95%).</p><p><strong>Conclusion: </strong>WVTT therapy in LP is associated with a higher risk of minor post-operative AEs, with similar functional outcomes at one year compared to SP. Longer follow-up studies are needed to compare the durability of treatment in LP.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"69"},"PeriodicalIF":2.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972385","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}