World Journal of Urology最新文献

{"title":"The views of women and their physicians on decision-making for stress urinary incontinence.","authors":"Nienke J E Osse, Karine Gontijo-Santos Lima, Marian K Engberts, Hugo W F van Eijndhoven, Philippe D Violette, Rufus Cartwright, Marco H Blanker, Paul L P Brand","doi":"10.1007/s00345-025-05668-4","DOIUrl":"10.1007/s00345-025-05668-4","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment decisions for stress urinary incontinence (SUI) are preference sensitive, because the disease is non-lethal and there are multiple reasonable treatment options. However, little is known about patients' and physicians' preferred decision-making styles for SUI. To aid physicians in their counselling and decision-making in consultations for SUI, we studied patients' and physicians' preferred and perceived decision-making in medical specialist consultations for SUI.</p><p><strong>Methods: </strong>This mixed-methods study combined the validated control preference scale (CPS) and the CPS perception version, and semi-structured, in-depth interviews with both patients and physicians. This study took place in Canada, the United Kingdom and the Netherlands. Sixteen physicians from all three countries and seventeen women from the Netherlands and Canada were interviewed.</p><p><strong>Results: </strong>All women expressed a preference for being involved in the decision-making process, either by informative or shared decision-making (SDM) in the CPS, because they valued the autonomy to make their own choice regarding treatment for SUI and appreciated receiving information and advice from their doctor. Physicians also preferred an involved patient, but used medical expertise to steer towards their preferred treatment option. Physicians found SDM difficult to understand, expressing different interpretations.</p><p><strong>Conclusions: </strong>SDM is not a precise concept either for patients or physicians, with multiple interpretations. All patients with SUI want to be involved in the decision-making process, either by informative or by shared decision-making. Physicians both express the desire to involve patients in their decision making, but conversely to steer patients towards the decision that they feel suits them best.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"329"},"PeriodicalIF":2.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151879","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":"Reusable vs. single use cystoscope: economic & environmental assessment.","authors":"Said Ait Taleb, Nicole Francois, Badr Eddine Tehhani, Thomas Perez","doi":"10.1007/s00345-025-05705-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05705-2","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce a scalable methodology for assessing the economic and environmental impacts of reusable versus single-use devices, with a novel approach of processing reusable devices through low-temperature sterilization (LTS) (STERRAD®).</p><p><strong>Methods: </strong>The economic analysis used micro-costing techniques while carbon footprint was calculated with two different methods: \"UO Sté method\" derived from Deschavannes et al. (2021) and an ISO 14040/14044 Life Cycle Assessment (LCA) of the sterilization of the reusable device performed with OPENLCA v2.4.0 software and ELCD v3.2 free database. The uncertainty analysis was performed with a Monte Carlo analysis. These methods were applied to a case study from cystoscopes procedures performed (2023).</p><p><strong>Results: </strong>Our LCA study indicates an annual reduction of 582.4 kg CO₂ equivalent (-14.5%) in favor of reusable devices. Regarding the economic impact, more specific to our case study, the findings suggest an annual cost savings of €108,484, (-29%). It is important to note that the analysis is based on an \"in-house\" LCA model. Additionally, this study provides an objective comparison without considering logistical challenges, personnel requirements, or implementation costs of reusable devices. It does not substitute the collaborative medical and paramedical judgment of a urology department.</p><p><strong>Conclusions: </strong>LTS of reusable cystoscopes seems to have a significant decrease of the environmental footprint and economic impact.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"323"},"PeriodicalIF":2.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136391","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":"Laser vs. bipolar prostate vaporization in bleeding-prone patients: a randomized trial and cutting-edge analysis.","authors":"Ahmed A Shorbagy, Mohammed Ismail, Youssef M Kotb, Mohamed Desouki, Mohamed Shabayek, Peter Hanna","doi":"10.1007/s00345-025-05692-4","DOIUrl":"10.1007/s00345-025-05692-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare effectiveness and safety of transurethral diode laser vaporization of prostate (diode LVP) versus bipolar transurethral vaporization of prostate (B-TUVP) in symptomatic benign prostatic hyperplasia (BPH) patients receiving oral anticoagulants/anti-platelet drugs.</p><p><strong>Patients and methods: </strong>All symptomatic prostate patients receiving oral anticoagulants/anti-platelet drugs are prospectively enrolled in the study between January 2023 to May 2024 in our institution. Of total 98 patients were randomized to B-TUVP (48 patients) or diode LVP (50 patients). The primary outcome is to compare B-TUVP with diode LVP regarding operative bleeding and postoperative hemoglobin drop. Secondary outcomes assess time of urinary irrigation, time of urethral catheter removal, length of hospital stays, and 6-month postoperative functional outcomes; IPSS, postoperative flow rate, and postvoid residual urine.</p><p><strong>Results: </strong>Baseline characteristics were similar in both groups. Diode LVP group had a significantly higher postoperative hemoglobin with a lower drop compared to B-TUVP group (p = 0.032, p = 0.007; respectively). The diode LVP group had a significantly reduced urinary irrigation duration compared to the B-TUVP group (p = 0.031). Also, diode LVP patients had early catheter removal compared to those in the B-TUVP group (p = 0.014). Additionally, the diode group had a notably reduced hospital stay duration compared to the B-TUVP group (p = 0.024). There were no significant differences between both groups regarding 6-month postoperative IPSS, Q max and PVRU.</p><p><strong>Conclusion: </strong>Diode LVP of the prostate is a safer alternative for treating BPH with fewer risks compared to B-TUVP especially in patients receiving anticoagulants. Nonetheless, both treatments yield similar 6-months functional outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"322"},"PeriodicalIF":2.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128936","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":"Youth matters: a systematic review of the molecular and clinical landscape of bladder cancer in young adults.","authors":"Ali Bourgi, Antoine Vincentelli, Emmanuel Rusch, Franck Bruyère","doi":"10.1007/s00345-025-05698-y","DOIUrl":"10.1007/s00345-025-05698-y","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer is uncommon in individuals under the age of 45, and its clinical and molecular characteristics in this population differ significantly from those observed in older patients. This systematic review aims to evaluate recurrence, progression, survival outcomes, and molecular profiles of bladder cancer in young adults.</p><p><strong>Methods: </strong>A systematic search was conducted in MEDLINE, Embase, Scopus, and CENTRAL databases for studies published between 1998 and 2024. Eligible studies included patients aged ≤ 40 years and reported outcomes such as recurrence-free survival (RFS), progression, and overall survival (OS). A total of 18 studies were included. Risk of bias was assessed using the ROBINS-I tool, and pooled estimates were calculated using random-effects meta-analysis models.</p><p><strong>Results: </strong>Bladder cancer in young adults is predominantly non-muscle-invasive and low-grade, with high survival rates. Recurrence rates varied across studies, ranging from 0 to 35.9%, while disease progression was rare. Several studies reported 100% RFS and OS in pediatric and young adult populations. The molecular profile of tumors in younger patients differed from that of older adults, with lower rates of TP53 and FGFR3 mutations. Meta-analysis revealed favorable long-term outcomes, particularly in patients diagnosed at early stages.</p><p><strong>Conclusion: </strong>Bladder cancer in young adults presents a distinct clinical and molecular entity with excellent prognosis, minimal progression, and high survival. Despite this, recurrence remains a concern, highlighting the need for age-specific surveillance strategies and further research into molecular drivers of the disease in this age group.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"321"},"PeriodicalIF":2.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128938","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 palliative transurethral resection of the prostate for lower urinary tract obstruction in patients with metastatic prostate cancer: a meta-analysis.","authors":"Reynier D Rodriguez Rosales, Jean-Pierre Trey Kanumuambidi, Arjun Venkatesh, Mohammed Al-Toubat, Nicole Murray, K C Balaji","doi":"10.1007/s00345-025-05664-8","DOIUrl":"https://doi.org/10.1007/s00345-025-05664-8","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aims to assess the safety, efficacy, and outcomes of palliative transurethral resection of the prostate (TURP) for relieving urinary obstruction in patients with metastatic prostate cancer.</p><p><strong>Methods: </strong>A comprehensive literature search was performed across PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar to identify studies published before August 2024. The included studies reported pre- and post-treatment outcomes in patients undergoing palliative TURP for urinary obstruction. Data were analyzed using Comprehensive Meta-Analysis and Review Manager software. Study quality was evaluated using the Newcastle Ottawa Scale, and bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.</p><p><strong>Results: </strong>Eight studies, including 3,080 patients with advanced prostate cancer, were included. Palliative TURP significantly reduced postvoid residual urine volume by a mean difference of 50.41 milliliters (95% confidence interval: 39.49-61.34, p < 0.00001) and improved the symptom score by 14.13 points (95% confidence interval: 10.03-18.23, p < 0.00001). However, no significant change was observed in the urinary flow rate (mean difference: 4.31 milliliters per second, p = 0.23). Reported complications included repeat TURP (23.4%), incontinence (13.9%), catheterization (10.8%), and TURP syndrome (2.7%).</p><p><strong>Conclusion: </strong>Palliative TURP effectively improves urinary symptoms and reduces urinary retention in patients with metastatic prostate cancer. While it offers symptomatic relief, the risk of postoperative complications should be carefully considered in treatment planning.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"320"},"PeriodicalIF":2.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121108","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":"Sand clearance vs. flowrate during ureteroscopy: studies in an in-vitro transparent kidney model.","authors":"Leilane Glienke, Timothy L Hall, William W Roberts","doi":"10.1007/s00345-025-05708-z","DOIUrl":"10.1007/s00345-025-05708-z","url":null,"abstract":"<p><strong>Purpose: </strong>Suction has recently been introduced into the ureteroscopic armamentarium to improve stone fragment and debris clearance. However, the benefits of suction appear to be limited by current irrigation systems. This study aimed to measure the time to clear sand ureteroscopically from a transparent silicone kidney-ureter model at different flowrates and compare with results with conventional pressurized irrigation and intermittent suction.</p><p><strong>Methods: </strong>A LithoVue™ Elite ureteroscope was inserted through a Clear Petra 11/13 Fr 46 cm or 12/14 Fr 50 cm FANS device into a transparent silicone kidney model. Irrigation was delivered from a peristaltic pump at rates of 18-90 ml/min with pump assisted outflow or from a pressurized source with suction assisted outflow. Intrarenal pressure (IRP) was maintained between 30-40 cmH₂O. Trials were conducted to measure the time required to completely aspirate 0.5 g of sand from the mid and upper calyces.</p><p><strong>Results: </strong>Sand was cleared more quickly from the kidney model as flowrate increased up to ~ 70-80 ml/min. Use of continuous flowrate was more efficient at clearing sand than variable flowrate produced by bursts of intermittent suction.</p><p><strong>Conclusions: </strong>Flowrate is a primary variable affecting efficiency of sand clearance in in vitro studies. Current clinical methods that utilize intermittent suction during ureteroscopy are likely less efficient than configurations that provide continuous flowrates. Incorporation of IRP feedback into irrigation systems may facilitate high flowrate while maintaining stable low IRP, thereby enhancing efficiency and safety of ureteroscopy.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"319"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111737","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":"Hydroxycitric acid inhibits ferroptosis and ameliorates benign prostatic hyperplasia by upregulating the Nrf2/GPX4 pathway.","authors":"Dayong Yang, Chengxi Zhai, Junyu Ren, Jinran Bai, Tao Li, Mingyao Lu, Yongjie Tang, Liangsheng Wei, Rongyao Luo, Fachun Tong","doi":"10.1007/s00345-025-05637-x","DOIUrl":"10.1007/s00345-025-05637-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Benign prostatic hyperplasia (BPH) poses a significant public health challenge, affecting a substantial portion of aging men worldwide. Current therapeutic options offer limited efficacy. The pathogenesis of BPH is multifactorial, involving ferroptosis, oxidative stress, and chronic inflammation. Hydroxycitric acid (HCA) is a natural compound with diverse pharmacological activities, including the inhibition of ferroptosis, anti-inflammatory, anti-oxidative stress, and anti-tumor effects. However, its role in BPH remains unexplored. This study aimed to investigate the effects of HCA on BPH and elucidate the underlying mechanisms, with the goal of providing novel therapeutic insights for BPH treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;C57BL/6J mice were used to establish a BPH model induced by testosterone propionate (TP). Animals were then randomly assigned to the following groups: Sham, BPH, BPH + Lip-1, BPH + Bru, BPH + HCA + Bru, and BPH + HCA. Prostate index (PI) was determined, and histopathological changes were evaluated by hematoxylin and eosin (HE) staining. Mitochondrial morphology was analyzed by TEM. The levels of Fe&lt;sup&gt;2+&lt;/sup&gt;, MDA, and GSH in prostate tissues were measured. Western blot analysis was performed to assess the protein expression of Nrf2 and GPX4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to the Sham group, the prostate tissues of the BPH group exhibited typical histopathological features of hyperplasia, including epithelial cell proliferation, increased glandular lumen size. Concurrently, the levels of ferroptosis markers Fe&lt;sup&gt;2+&lt;/sup&gt; (P &lt; 0.01) and MDA (P &lt; 0.001) were significantly elevated, while the expression of GSH (P &lt; 0.01) and GPX4 (P &lt; 0.05) was downregulated. Furthermore, mitochondrial morphology showed abnormalities. HCA treatment significantly reduced PI (P &lt; 0.01) and attenuated epithelial cell proliferation and glandular lumen enlargement (P &lt; 0.01, P &lt; 0.001, respectively). HCA also reduced the levels of Fe&lt;sup&gt;2+&lt;/sup&gt; (P &lt; 0.05) and MDA (P &lt; 0.05), and elevated GSH levels (P &lt; 0.01). Furthermore, HCA upregulated the expression of Nrf2 (P &lt; 0.01) and GPX4 (P &lt; 0.01). The Nrf2 inhibitor Brusatol increased the levels of Fe&lt;sup&gt;2+&lt;/sup&gt; (P &lt; 0.05) and MDA (P &lt; 0.05), and downregulated the expression of Nrf2 (P &lt; 0.05) and GPX4 (P &lt; 0.05), thereby attenuating the protective effects of HCA. However, co-administration of HCA and Brusatol partially reversed changes in Fe&lt;sup&gt;2+&lt;/sup&gt; (P &lt; 0.05) and MDA (P &lt; 0.05) levels, and increased the expression of Nrf2 (P &lt; 0.05) and GPX4 (P &lt; 0.05), indicating reduction in Brusatol-induced effects. Furthermore, HCA treatment did not significantly affect liver and kidney function markers (AST, ALT, SCR, and UR) (P &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;HCA inhibits ferroptosis by activating the Nrf2/GPX4 pathway, thereby ameliorating the pathological changes in BPH induced by TP. This study suggests a novel therapeutic strategy for BPH.&lt;","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"318"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111475","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":"Can ureteral stents be omitted from radical cystectomy with continent diversion? An ACS-NSQIP analysis of the early postoperative outcomes.","authors":"Yara Ghandour, Baraa AlJardali, Towfik Sebai, Marwan Zein, Jad Najdi, Albert El Hajj","doi":"10.1007/s00345-025-05685-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05685-3","url":null,"abstract":"<p><strong>Purpose: </strong>Radical cystectomy with continent diversion is the standard treatment for muscle-invasive bladder cancer. Evidence supporting the necessity of ureteral stent use after this procedure is limited. This study compares 30-day postoperative outcomes of radical cystectomy with continent diversion using neobladder reconstruction in patients managed with and without ureteral stents.</p><p><strong>Methods: </strong>A retrospective cohort study using the 2019-2022 ACS-NSQIP database included 1,318 patients who underwent radical cystectomy with continent diversion using neobladder reconstruction. We compared baseline characteristics and perioperative factors between the stented (n = 1,216) and stentless group (n = 102). Univariate and multivariate analyses assessed the relationship between stent use and perioperative outcomes, as well as 1:1 propensity score matching.</p><p><strong>Results: </strong>Patient demographics and comorbidities were comparable between the two groups. Similarly, preoperative and intraoperative factors showed no significant differences, except for a higher drain placement rate in the stented group (98.6% vs. 89.2%, p < 0.001). Postoperatively, the stented cohort exhibited higher odds of minor complications (CD grade 1-2; OR 1.66, p = 0.018), and an increased incidence of progressive renal insufficiency (8.7% vs. 1.3%, p = 0.024) and bleeding requiring transfusion (29.8% vs. 19.6%, p = 0.030). Ureteral obstruction, urinary leak, anastomotic leak rates, hospital stay, and readmission and reoperation rates remained similar between the two groups. Propensity score matching (1:1) for patients with and without stents supported the results of the multivariate logistic regression.</p><p><strong>Conclusion: </strong>Stent omission after radical cystectomy with continent diversion using neobladder reconstruction was not associated with significant differences in major complications, ureteral obstruction, readmission, or reoperation rates. It is potentially a safe alternative associated with fewer minor complications.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"314"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095157","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":"Organizational impact of systematic urine culture before Bacillus Calmette Guerin (BCG) induction instillations.","authors":"Quentin Jock, Laura I Levi, Matthieu Lafaurie, Annabelle Goujon, Pierre Mongiat Artus, Paul Meria, Francois Desgrandchamps, Alexandra Masson Lecomte, Emilien Seizilles de Mazancourt","doi":"10.1007/s00345-025-05671-9","DOIUrl":"https://doi.org/10.1007/s00345-025-05671-9","url":null,"abstract":"<p><strong>Purpose: </strong>There are conflicting recommendations concerning the performance of a systematic urine culture (UC) prior to Bacillus Calmette Guerin (BCG) bladder instillations for non-muscle-invasive bladder tumor. The objective was to study the organizational impact of the UC performed before bladder instillations, defined as the number and proportion of BCG instillations postponed due to a positive urine culture result.</p><p><strong>Methods: </strong>Induction BCG records in a single academic center between 2015 and 2020 were retrospectively reviewed. All patients had a UC prior to each instillation, treated if positive. Risk factors associated with the occurrence of a positive UC, an adverse event or postponement of instillation were studied.</p><p><strong>Results: </strong>A total of 156 patients were included, among which 68.9% of patients had at least one risk factor of UTI and 33% of patients presented at least one positive UC at induction. During BCG induction, 76/909 (8.4%) urine cultures performed were positive and 33% of patients had at least one postponement of BCG instillation. There were 64 instillations postponed, caused by untreated positive urine culture for 40 (62.5%) and absence of urine culture performed for 6 (9.4%) In multivariate analysis, only the presence of lower urinary tract symptoms was significantly associated with a risk of positive UC.</p><p><strong>Conclusion: </strong>Positive UC during BCG instillations is a frequent event and a source of disorganization in BCG induction, with possible oncological consequences. A strategy of performing UC only in selected patients, could facilitate proper BCG administration and avoid unreasonable use of antibiotics.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"316"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095063","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":"Comment on \"Is flexible navigable suction ureteral access sheath (FANS) safer and more efficient than conventional sheaths? Italian multicentric experience\".","authors":"Daniele Castellani, Angelo Cormio, Khi Yung Fong, Steffi Kar-Kei Yuen, Vineet Gauhar","doi":"10.1007/s00345-025-05697-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05697-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"315"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095160","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}