World Journal of Urology最新文献

{"title":"Association between the use of proton pump inhibitors and serum PSA levels in the general U.S. population.","authors":"Fabio Bioletto, Giorgio Calleris, Luigi Simone Aversa, Marco Oderda, Giancarlo Marra, Mirko Parasiliti-Caprino, Iacopo Gesmundo, Riccarda Granata, Paolo Gontero, Ezio Ghigo","doi":"10.1007/s00345-025-05469-9","DOIUrl":"10.1007/s00345-025-05469-9","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are widely prescribed drugs that have been associated with increased prostate cancer (PCa) cell proliferation in vitro and worse oncological outcomes in vivo. However, data on their influence on PSA levels in the general population are lacking.</p><p><strong>Methods: </strong>We extracted individual participant data from the 2001-2010 cycles of the National Health and Nutrition Examination Survey (NHANES), in which PSA levels were measured in all male participants aged 40 years or older. The association of PPI use with total PSA levels and free/total PSA ratio was evaluated through multivariable linear regression analyses, adjusted for potential confounders.</p><p><strong>Results: </strong>A total of 7366 subjects were included (median age: 53 years; median serum PSA: 0.9 ng/mL), of whom 746 were receiving PPI treatment at the time of the study. After adjustment for potential confounders, ongoing PPI use was associated with lower total PSA levels (-0.24 ng/mL, 95%CI: [-0.37,-0.11], p < 0.001), while no significant association with free/total PSA ratio was found (p = 0.881). A significant effect modification was observed according to age, with the association being limited to older participants (≥ 60 years) at stratified analyses.</p><p><strong>Conclusions: </strong>Contrary to the available data in the context of PCa, we found no evidence of increased PSA levels in PPI users with no prostate malignancy. Instead, PPI use was associated with a decrease of total PSA in older adults. This adds knowledge on how PPIs may influence PSA in population-based screening programs.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"133"},"PeriodicalIF":2.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469226","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":"The advanced lung cancer inflammation index as a useful prognostic indicator for patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma.","authors":"Tomoya Hatayama, Keisuke Goto, Yuki Kohada, Kensuke Nishida, Takeshi Ueno, Tomoki Furutani, Kunihiro Hashimoto, Kenshiro Takemoto, Miki Naito, Shunsuke Miyamoto, Kohei Kobatake, Yohei Sekino, Hiroyuki Kitano, Akihiro Goriki, Keisuke Hieda, Nobuyuki Hinata","doi":"10.1007/s00345-025-05505-8","DOIUrl":"10.1007/s00345-025-05505-8","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the ability of the advanced lung cancer inflammation index (ALI) to predict the prognosis of patients who underwent radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). We also aimed to compare the ALI with other inflammatory or nutritional indices as prognostic indicators.</p><p><strong>Methods: </strong>We retrospectively evaluated patients who underwent RNU for UTUC at multiple centers between January 2010 and April 2024. We calculated the ALI before RNU and divided the patients into the low ALI and high ALI groups. We used 1:1 propensity score matching (PSM) to adjust the clinicopathological differences between two groups. We compared the overall survival (OS) and recurrence-free survival (RFS) of the low and high ALI groups using the Kaplan-Meier method. Furthermore, we assessed the ALI as a predictor of OS and RFS using a multivariate Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>Of 488 patients (48.3% low ALI group), 160 patients from each group were matched. The Kaplan-Meier analysis revealed that the OS (p = 0.009) and RFS (p = 0.006) of the low ALI group were significantly shorter than those of the high ALI group. According to a multivariate analysis that included clinicopathological prognostic indicators, a low ALI was an independent predictor of poor OS (p = 0.014) and RFS (p = 0.038). Furthermore, according to the multivariate analysis including other inflammatory or nutritional indices, the ALI was an independent predictor of poor OS (p = 0.024) and RFS (p = 0.044).</p><p><strong>Conclusions: </strong>The ALI was a significantly useful prognostic predictors of patients with UTUC who underwent RNU.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"132"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459629","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":"Is it necessary for patients with a positive urine culture to achieve a negative result after antimicrobial treatment before undergoing percutaneous nephrolithotomy?","authors":"Junhao Zheng, Qixian Guo, Gaoyuanzhi Yue, Shangwen Dou, Xueqing Zeng, Tao He, Fuyang Lin, Renfei Liu, Qiansheng Zhang, Zijie Mai, Yongda Liu","doi":"10.1007/s00345-025-05484-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05484-w","url":null,"abstract":"<p><strong>Objective: </strong>There is ongoing debate regarding whether patients with a positive urine culture (UC) need to wait for the culture to turn negative following antimicrobial treatment before undergoing percutaneous nephrolithotomy (PCNL). This study aimed to evaluate the necessity of achieving a negative UC before PCNL and its association with postoperative systemic inflammatory response syndrome (SIRS) and sepsis.</p><p><strong>Methods: </strong>This prospective study included 147 patients with positive UCs who underwent PCNL at The First Affiliated Hospital of Guangzhou Medical University from March 2021 to April 2024. Patients were treated with sensitive antibiotics for 5-7 days based on the susceptibility results of their initial UC. Follow-up UCs were performed on day 3 after starting antibiotics and immediately before surgery. The relationship between UC results and postoperative infectious complications, including SIRS and sepsis, was analyzed. Multivariable analysis was conducted to identify independent risk factors.occurrence of postoperative infectious complications, including SIRS and sepsis, was analyzed. Multivariable analysis was used to identify independent risk factors.</p><p><strong>Results: </strong>Among the 147 patients, 133 (90·5%) had a negative urine culture on day 3 of treatment, while 14 remained positive. Preoperatively, 136 patients (92·5%) had negative UCs. Univariate analysis showed no significant differences in the incidence of postoperative systemic inflammatory response syndrome (SIRS) and sepsis between the UC-negative and UC-positive groups on day 3 and preoperatively (p > 0·05). Multivariable analysis identified stone burden (OR 1·01, 95% CI 1·01-1·01, p = 0·009), multiple access tracts (OR 2·64, 95% CI 1·08 - 6·45, p = 0·034), and positive stone cultures (OR 5·03, 95% CI 1·84 - 13·74, p = 0·002) as independent risk factors for postoperative SIRS. Bacterial variations were observed in follow-up UCs from 8 patients, but these did not impact postoperative complications.</p><p><strong>Conclusion: </strong>Achieving a negative UC before PCNL is not a necessary condition. Patients with positive UCs can safely undergo surgery after 5 days or more of sensitive antibiotic treatment without the need for a negative UC result. Positive stone cultures are valuable predictors of postoperative SIRS, supporting the routine collection of stone culture specimens.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"131"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459701","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 incidence and classification of intraoperative adverse events in urological surgery: a systematic review.","authors":"Gernot Ortner, Charalampos Mavridis, Athanasios Bouchalakis, Maria Chrisoula Nakou, Yuhong Yuan, Udo Nagele, Charalampos Mamoulakis, Thomas R W Herrmann, Chandra Shekhar Biyani, Theodoros Tokas, Mithun Kailavasan","doi":"10.1007/s00345-025-05509-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05509-4","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a systematic review (SR) to examine the application of classification systems (CS) used to report intraoperative adverse events (iAEs) in urological surgery and to evaluate the crude incidence and type of iAEs.</p><p><strong>Materials and methods: </strong>This review was published via PROSPERO (CRD42024549954) and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). MEDLINE, Embase, and the Cochrane CENTRAL were searched using a predefined PICO framework: (P) patients with benign and malignant urological diseases, (I) all types of urological surgery, (C) none/any, (O) intraoperative complications classified with grading systems. Retrospective and prospective studies published between January 2019 and June 2024 were included.</p><p><strong>Results: </strong>The search yielded 1,570 abstracts, 1,043 full-text articles were assessed for eligibility, of which 325 studies reported iAEs (54 used iAE-CS, 64 used Clavien-Dindo Classification and 207 used free-text descriptions). Of the 54 studies (15,298 patients) that used an iAE-CS, the three most used systems were the EAUiaiC (54%), SATAVA (26%), and the modified SATAVA (7%). The overall incidence of iAE was 14% (2,153/15,225 patients). On a study level, the crude incidence of iAE was between 0 and 100% (median 7%, IQR: 3-13%). The misapplication of the Clavien-Dindo system to describe iAEs was high (n = 64 studies).</p><p><strong>Conclusions: </strong>The use of iAE-CS is scarce, and there is a lack of universal consensus on a CS to describe iAEs. iAE are poorly reported in urological studies. Urologists should report all perioperative complications to improve transparency and surgical and hospital processes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"129"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450177","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 analysis of trifecta and pentafecta outcomes in T1a and T1b renal tumors following robotic partial nephrectomy: a retrospective study.","authors":"Rakesh Sharma, S Lohith, Amaresh Mohan, Bhasker Reddy, Rohit Singh, Manoj Kharadae, Vivek Meyyappan, Srikanth Srirama","doi":"10.1007/s00345-025-05497-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05497-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to conduct a comparative analysis of Trifecta and Pentafecta outcomes between T1a and T1b renal tumors in patients undergoing robotic partial nephrectomy (RAPN). We explore the influence of clinical factors, including the RENAL nephrometry score components, on these outcomes.</p><p><strong>Methods: </strong>A retrospective single centre study was conducted on 133 patients who underwent RAPN for T1a (n = 51) and T1b (n = 82) renal tumors between 2017 and 2023. We assessed Trifecta and Pentafecta outcomes, and statistical comparisons were made. Univariate and multivariate analyses were conducted to evaluate the impact of tumor size and RENAL components on these outcomes.</p><p><strong>Results: </strong>Trifecta was achieved in 84.3% of T1a tumors and 85.36% of T1b tumors (p = 0.86). Pentafecta outcomes were achieved in 60.8% of T1a and 41.46% of T1b tumors (p = 0.34). Warm ischemia time was significantly longer in T1b tumors (p = 0.037). In the univariate analysis, warm ischemia time and tumor size were significant predictors of Trifecta and Pentafecta outcomes, respectively. Nearness to the collecting system was also a significant factor in univariate analysis (p = 0.045). Other clinical factors such as exophytic/endophytic properties and location relative to polar lines did not significantly impact outcomes.</p><p><strong>Conclusion: </strong>RAPN is equally effective for T1a and T1b renal tumors, providing comparable Trifecta and Pentafecta outcomes. Warm ischemia time, tumor size, and nearness to the collecting system are important factors influencing these outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"130"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459698","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":"Comparing different 3D virtual models generations for the planning of robotic partial nephrectomy: the added value of perfusion volumes implement.","authors":"Daniele Amparore, Federico Piramide, Mariano Burgio, Martina Mandaletti, Marco Colombo, Alexandru Turcan, Federico Rubat Baleuri, Enrico Checcucci, Sabrina De Cillis, Alberto Piana, Michele Di Dio, Matteo Manfredi, Cristian Fiori, Francesco Porpiglia","doi":"10.1007/s00345-025-05504-9","DOIUrl":"https://doi.org/10.1007/s00345-025-05504-9","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study is to evaluate the role of a new generation of 3D virtual models (3DVM) implemented with perfusion volumes algorithm, in influencing perioperative and functional outcomes after robotic partial nephrectomy (RAPN).</p><p><strong>Methods: </strong>A perfusion volume 3DVM was built using Voronoi diagram-based algorithm for all the organ-confined renal masses candidate for RAPN from 12/2019 to 12/2022. On its basis, a selective or super-selective clamping was planned. A sub-cohort of patients underwent renal scintigraphy (RS), evaluating estimated renal plasmatic flow (ERPF). Data were compared with a retrospectively selected control group in which the surgery was assisted by 3DVM without perfusion volume assessment.</p><p><strong>Results: </strong>116 and 217 were considered. In 77 (67.5%) and 81 (37.3%) patients a selective or super-selective clamping was performed, in the study and control group respectively (p < 0.001). A higher rate of third-order artery clamping was recorded in the study group (42/77 vs. 26/81, p 0.004). No difference was found in terms of postoperative complications (overall postoperative: 17.2% and 19.3%; major complications: 3.4% and 3.2%). Clamping strategy failure was recorded in 5 (4.3%) and 26 (11.9%) (p 0.02). A significant ERPF drop (> 20%) was recorded in 3/51 (5.8%) and 16/82 (19.5%) patients in study and control group, respectively (p 0.04). Similarly, median delta ERPF resulted different between the groups (-10.69% vs. -18.92%, p < 0.001).</p><p><strong>Conclusions: </strong>Perfusional volumes 3DVMs, lead the surgeon to perform a higher rate of effective selective and super-selective clampings, translating in higher rates of renal units functionally saved.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"126"},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441937","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 suggested dosage and course of thiazide diuretics on preventing recurrent urolithiasis: an upstate meta-analysis.","authors":"Li Yi, Hui Wang, Yu Ji, Yuxuan Zhao, Qinglong Du, Laiyuan Qiu, Lei Yan, Dawei Li","doi":"10.1007/s00345-025-05503-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05503-w","url":null,"abstract":"<p><strong>Background: </strong>Over the past few decades, many studies assessing the effect of thiazide diuretics showed controversial results. Additionally, recent guidelines fail to address the optimal dosage and treatment duration of thiazide diuretics. Therefore, we conducted a meta-analysis to evaluate the efficacy, optimal dosage, and treatment duration of thiazide diuretics in preventing recurrent urolithiasis.</p><p><strong>Methods: </strong>We conducted a comprehensive search of three electronic databases (PubMed, Embase and Cochrane Library) up to January 2024, utilizing specific keywords to identify eligible studies. Subsequently, we performed an overall meta-analysis. Subgroup analysis was also performed to evaluate the efficacy, optimal dosage, and treatment duration of thiazide diuretics.</p><p><strong>Results: </strong>Twelve eligible studies were included, with a total of 1217 patients. Overall, our findings demonstrated the efficacy of thiazide diuretics in preventing recurrent urolithiasis (RR = 0.55, 95% CI = 0.39 to 0.76). The Egger's test indicated that our analysis was free of publication bias (P = 0.092). In the dose-effect analysis, we observed that hydrochlorothiazide group using daily doses of 50 mg was statistically effective. Regarding the treatment duration, we found that treatment with all thiazide diuretics for ≤ 12 monthswas statistically insignificant, while treatment with all thiazide diuretics for 24 and 36 months was demonstrated to be effective. Treatment with hydrochlorothiazide for 36 months was also demonstrated to be effective.</p><p><strong>Conclusions: </strong>We demonstrated the efficacy of thiazide diuretics in preventing recurrent urolithiasis. For the optimal dosage and treatment duration, we recommend a daily dose of 50 mg of hydrochlorothiazide for 36 months.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"127"},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441969","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":"Vacuum-assisted dedusting lithotripsy: a retrospective comparative study in high-risk patients with positive preoperative urine cultures.","authors":"Junjie Liang, Zhonghua Shen, Linguo Xie, Chunpeng Li, Xingwang Qi, Chunyu Liu","doi":"10.1007/s00345-025-05510-x","DOIUrl":"https://doi.org/10.1007/s00345-025-05510-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the efficacy of vacuum-assisted dedusting lithotripsy (VADL), employing a flexible vacuum-assisted ureteral access sheath (FV-UAS), with traditional flexible ureteroscopic lithotripsy (fURL) for upper urinary tract stones in patients with positive urine cultures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 421 patients treated with fURL between January 2022 and August 2024. Patients were divided into a traditional fURL group and a VADL group. Propensity score matching adjusted for baseline differences, with a 1:1 ratio applied to compare stone-free rates, operative durations, postoperative hospital stay durations, and postoperative infectious complications.</p><p><strong>Results: </strong>Among 114 well-matched patients in each group, no mortalities occurred. The VADL group demonstrated significantly lower incidences of postoperative systemic inflammatory response syndrome (SIRS) (7.0% vs. 15.8%, p = 0.037) and shorter hospital stays (2.0 [1.0, 2.0] vs. 1.0 [1.0, 2.0], p = 0.014). The stone-free rate was significantly higher in the VADL group (87.7% vs. 72.8%, p = 0.005). However, no significant differences were observed in postoperative fever incidence or operative duration (7.0% vs. 9.6%, p = 0.472; 55.5 [40.0, 75.0] vs. 60.0 [45.0, 75.0], p = 0.104).</p><p><strong>Conclusions: </strong>VADL significantly reduces postoperative infectious complications and enhances stone-free rates in patients with upper urinary tract stones and positive preoperative urine cultures undergoing ureteroscopic lithotripsy.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"128"},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442018","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":"Micro-costing analysis of Rezum™ therapy: comparing sedation and local anesthesia with the Schelin® catheter.","authors":"Yasmine Saibi, Thibaut Long-Depaquit, Marc Fourmarier, Alessandro Uleri, Jennifer Campagna, Cyrille Bastide, Florence Peyron, Michael Baboudjian","doi":"10.1007/s00345-025-05472-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05472-0","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"124"},"PeriodicalIF":2.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426263","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":"Crossed paths: a systematic review unveiling patterns in crossed testicular ectopia.","authors":"Catherine Robey, Tanisha Martheswaran, Tijesunimi Oni, Jason Yang, David Heap, Victoria Maxon, Chad Crigger","doi":"10.1007/s00345-025-05471-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05471-1","url":null,"abstract":"<p><strong>Purpose: </strong>Crossed Testicular Ectopia (CTE) is a rare congenital anomaly where both testes descend on one side of the body. Although previously believed to be exceedingly uncommon, the number of published cases has grown, suggesting it may be more prevalent than initially believed. CTE is associated with various abnormalities, of which the most cited anomaly is persistent mullerian duct syndrome (PMDS) which has its own implications regarding infertility. This systematic review aims to clarify the impact of CTE on fertility, histopathology, associated congenital abnormalities, and potential long-term outcomes.</p><p><strong>Methods: </strong>A systematic review of the literature was performed to identify relevant studies on CTE. Inclusion criteria covered case reports, case series, and meta-analyses with individual case data published in English. Two reviewers independently extracted data, including demographic details, diagnostic methods, histological findings, and fertility status. Data analysis was performed using JMP software.</p><p><strong>Results: </strong>We identified 417 cases of CTE, a significant increase from previous review. CTE was diagnosed preoperatively in only 42.6% of cases, with ultrasound and MRI achieving the highest diagnostic success rates. Histological abnormalities were common, observed in 66% of cases, including testicular dysgenesis, Leydig cell hyperplasia, and malignancy. Infertility was reported in 79.2% of patients, notably high even among those with unilateral undescended testes. Fusion anomalies involving the spermatic cord, vas deferens, or testes were documented in 9.5% of cases. PMDS was the most common associated anomaly, identified in 33.3% of cases, and appeared to reduce the likelihood of fusion anomalies.</p><p><strong>Conclusion: </strong>This review highlights CTE as a complex and potentially underdiagnosed condition with significant implications for fertility and cancer risk. Early diagnosis and intervention are essential to improving long-term outcomes, while future research should investigate the genetic factors underlying CTE and optimize diagnostic protocols.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"125"},"PeriodicalIF":2.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426224","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}