World Journal of Urology最新文献

{"title":"Clinical outcomes and health-related quality of life assessment following minimally invasive reconstructive surgery for benign ureteral strictures.","authors":"Quan Zhang, Hanqing Wang, Xuemeng Zhang, Zhenhua Gao, Hao Li, Baiyu Zhang","doi":"10.1007/s00345-025-05926-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05926-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the clinical efficacy of minimally invasive ureteral reconstruction for benign strictures and analyze its impact on health-related quality of life (HRQoL) and psychological status.</p><p><strong>Methods: </strong>This retrospective study included 29 patients undergoing robotic/laparoscopic ureteral reconstruction at our institution. Surgical outcomes were assessed through imaging, laboratory parameters, and patient-reported outcomes assessed via the validated SF-36 quality-of-life instrument and Hospital Anxiety and Depression Scale (HADS) psychological distress screening tool.</p><p><strong>Results: </strong>With a median follow-up of 12 months, the surgical success rate was 96.6%. The perioperative complication rate was 6.90% (2 cases of transient high fever), with no severe adverse events observed. Preoperative SF-36 scores in physical functioning (PF) and bodily pain (BP) domains were significantly lower than those of the general population (p < 0.001). Postoperatively, except for vitality(VT) and mental health (MH) domains which surpassed population norms, scores in other dimensions showed no significant differences compared to the general population (p > 0.05). Notably, all SF-36 domains demonstrated significant improvement from baseline (p < 0.05). Additionally, both anxiety and depression scores assessed by HADS decreased markedly after surgery (p < 0.05).</p><p><strong>Conclusion: </strong>Minimally invasive ureteral repair and reconstruction effectively relieves obstruction, improves renal function, and significantly enhances health-related quality of life and psychological well-being, representing a safe therapeutic option for benign ureteral strictures. Surgical intervention reduces the need for long-term stent or nephrostomy placement, thereby alleviating physical and psychological burdens. Further studies with expanded cohorts and extended follow-up durations are warranted to validate long-term outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"558"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076094","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":"Characterizing pelvic organ descent in women after radical cystectomy: an exploratory analysis.","authors":"Cheyenne Williams, Ruchika Talwar, Parvati Ramchandani, Ariana L Smith","doi":"10.1007/s00345-025-05918-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05918-5","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of radical cystectomy (RC) on female pelvic floor support remains poorly understood; we aim to characterize the prevalence and severity of pelvic organ descent beyond the pubococcygeal line (PCL) in women who have undergone RC.</p><p><strong>Methods: </strong>We retrospectively reviewed charts of women who underwent RC at our institution from 2017 to 2020. Using cross-sectional static imaging we measured pelvic organ position preoperatively, postoperatively, and throughout the surveillance period, as determined by intestinal position in relation to the PCL on sagittal images obtained in the supine position. Imaging review protocol was developed in collaboration with an expert genitourinary radiologist. We also recorded relevant covariates, including age, race/ethnicity, BMI, vaginal parity, pre-cystectomy prolapse, prior hysterectomy, constipation, and chronic cough.</p><p><strong>Results: </strong>We identified 48 women with ≥ 1 preoperative and ≥ 1 postoperative scan who underwent RC at our institution out of a total of 80 female cystectomies in the study period. The majority underwent ileal conduit (83%) and non-organ sparing RC (81%). Median pelvic organ proximity to the PCL was significantly closer pre-operatively at 2 mm (IQR: -4, 6) below the PCL versus post-operatively at 14 mm (IQR: 9, 20) (p < 0.001). On scans with maximum organ descent, 96% of patients had increased organ descent from baseline. Median time to maximum descent was 9 months (IQR 3.8, 19.1). Patients undergoing continent diversions had greater post-operative descent than those with incontinent diversions. Vaginal deliveries were independently significantly associated with longer pelvic organ descent beyond the PCL (exp. β = 1.87 [95% CI: 1.21, 2.88; p = 0.009]).</p><p><strong>Conclusion: </strong>We describe the novel use of pre- and post-operative surveillance cross sectional imaging to characterize the natural history of post-RC pelvic floor descent. In our population, 96% of women demonstrate increased pelvic organ descent after RC on supine static imaging. Descent of pelvic floor support is an underappreciated consequence of RC.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"559"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076164","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":"Sterile water injections for analgesia in renal colic: a meta-analysis of level 1 evidence.","authors":"Ioannis Perros, Balamrit Singh Sokhal, Christopher Swift, Mark Kitchen, Christian Mallen, Bhaskar Somani","doi":"10.1007/s00345-025-05920-x","DOIUrl":"10.1007/s00345-025-05920-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of Sterile water injections (SWIs) for acute pain relief in renal colic.</p><p><strong>Methods: </strong>This study was conducted in accordance with the Preferred Reporting items for Systematic Reviews and Meta-Analyses. MEDLINE, CINAHL, Web of Science and Cochrane were searched to identify randomised controlled trials (RCTs) comparing SWIs with placebo or other analgesics in renal colic patients. Data were pooled and analysed using random effects modelling with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Six RCTs including 1322 renal colic patients were included, with 466 (35.2%) receiving SWIs. Patients receiving SWIs had comparable demographics and presenting features to the control groups, with control medications ranging from placebos, non-steroidal anti-inflammatories, and opioids. Self-reported pain scores at 30 min following intervention were lower in SWI than placebo (MD = - 4.63, 95% CI: - 5.16, - 4.10, P < 0.001) and other analgesics (MD = - 0.36, 95% CI: - 0.52, - 0.21, P < 0.001). The use of rescue analgesia was lower in those receiving SWIs compared to placebo (OR = 0.24, 95% CI: 0.10, 0.59, P = 0.002) and other analgesics (OR = 0.46, 95% CI: 0.29, 0.74, P = 0.001). No significant side effects were attributed to SWI use.</p><p><strong>Conclusions: </strong>SWIs demonstrated superior pain relief and reduced rescue analgesia requirements, compared to placebo and standard treatment, offering a promising alternative for patients where traditional options are unsuitable.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"557"},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070617","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":"A prospective evaluation of hidden bacterial involvement and antibiotic efficacy in nonbacterial CP/CPPS: addressing an underexplored therapeutic approach.","authors":"Hiroyuki Kitano, Hiroki Ohge, Kayoko Tadera, Yuki Kohada, Tomoya Hatayama, Hiroyuki Shikuma, Ryo Tasaka, Kenshiro Takemoto, Shunsuke Miyamoto, Kohei Kobatake, Yohei Sekino, Hiroki Kitagawa, Seiya Kashiyama, Nobuyuki Hinata","doi":"10.1007/s00345-025-05936-3","DOIUrl":"10.1007/s00345-025-05936-3","url":null,"abstract":"<p><strong>Purpose: </strong>To identify bacteria potentially involved in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) classified as nonbacterial and evaluate the clinical effectiveness of antibiotic therapy against these pathogens.</p><p><strong>Methods: </strong>Patients were classified into two groups-CP/CPPS category IIIb and the bacterial prostatitis subgroup of CP/CPPS-based on the presence or absence of pyuria and bacteriuria in urine samples obtained before and after prostatic massage. Treatment efficacy was compared between the two groups. The bacterial prostatitis subgroup was further stratified according to whether uropathogens or non-uropathogens were detected, and treatment responses were analyzed accordingly.</p><p><strong>Results: </strong>A total of 28 patients were classified in the CP/CPPS category IIIb and 17 patients in the bacterial prostatitis subgroup. The bacterial prostatitis subgroup showed a significantly greater reduction in National Institutes of Health-Chronic Prostatitis Symptom Index total scores compared with the IIIb group, particularly in the pain domain, which also showed significant improvement over time. The quality-of-life scores also improved in this subgroup. Within the bacterial prostatitis subgroup, both uropathogen-positive and non-uropathogen-positive patients showed a reduction in pain scores, with significantly greater improvement observed in the non-uropathogen group.</p><p><strong>Conclusion: </strong>These findings suggest that some patients classified as CP/CPPS category IIIb under conventional diagnostic methods may, in fact, have bacterial involvement. Antibiotic therapy may be effective in such cases, including those with non-uropathogenic bacterial detection.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"554"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070661","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":"Comparison of dusting and fragmentation techniques using an aspiration access sheath: an in vitro study.","authors":"Engin Denizhan Demirkıran, Reha Girgin, Umut Can Karaarslan, Murat Can Kiremit, Tarık Emre Şener","doi":"10.1007/s00345-025-05935-4","DOIUrl":"10.1007/s00345-025-05935-4","url":null,"abstract":"<p><strong>Purpose: </strong>Suction during flexible ureteroscopy improves stone clearance and lowers complications. The aim of this study is to provide one of the first in vitro comparisons of dusting and fragmentation techniques during laser lithotripsy using an aspiration access sheath.</p><p><strong>Methods: </strong>The bench model consisted of a modified 50-cc syringe that served as a calyx model, into which an 11-13 Fr suction access sheath and artificial BegoStone stones were placed. Three trials were performed by 3 surgeons using Thulium Fiber Laser (TFL) for lithotripsy, using both dusting and fragmentation settings and techniques. The primary outcomes were evaluation of energy usage, particle size distribution, procedural efficiency and scope entry-exit count.</p><p><strong>Results: </strong>Fragmentation showed shorter lasing times (31.15 vs 45.15 min, p < 0.001) and greater ablation efficacy (29.64 vs 24.55 mm³/J, p < 0.001). Nevertheless, it necessitated longer suction durations (14.11 vs 5.77 min, p = 0.001) due to larger particle sizes and the need for more frequent scope entries (16 vs 4, p < 0.001). Dusting consumed more energy (40.73 vs 33.73 kJ, p < 0.001) but produced finer fragments.</p><p><strong>Conclusion: </strong>Fragmentation using an aspiration sheath shortens the lasing time and improves ablation efficacy, but it also increases the frequency of scope entries and may result in endoscope damage. Dusting produces a finer particle dispersion despite using more energy. The choice of technique should be tailored to the demands of the patient and the surgeon.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"552"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065809","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: \"Vibegron in overactive bladder: a comprehensive review of efficacy, safety and patient-reported outcomes\".","authors":"Antonio Alcántara Montero","doi":"10.1007/s00345-025-05942-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05942-5","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"553"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065858","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":"Initial clinical experience with 6.3 Fr single‑use flexible ureteroscope versus 8.5 Fr in retrograde intrarenal surgery with flexible and navigable suction ureteral access sheath of variable diameters: a single‑center comparative study.","authors":"Dongfeng Yuan, Yang Xun, Steffi Kar Kei Yuen, Junyi Yang, Yirixiatijiang Amier, Wenlong Wan, Yongqi Wang, Weimin Yao, Xiao Yu","doi":"10.1007/s00345-025-05940-7","DOIUrl":"https://doi.org/10.1007/s00345-025-05940-7","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"556"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070607","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 parameters-based machine learning models for predicting intraoperative hemodynamic instability in hypertensive pheochromocytomas and paragangliomas patients.","authors":"Houming Zhao, Lu Tang, Zhuoran Li, Xintao Li, Tongyu Jia, Jin Luo, Yujie Dong, Shangwei Li, Xin Ma, Peng Zhang","doi":"10.1007/s00345-025-05890-0","DOIUrl":"10.1007/s00345-025-05890-0","url":null,"abstract":"<p><strong>Purpose: </strong>To create machine learning (ML) models based on inflammatory markers and coagulation parameters for predicting intraoperative hemodynamic Instability (HI) in sustained hypertensive patients with pheochromocytomas and paragangliomas (PPGLs).</p><p><strong>Methods: </strong>197 sustained hypertensive PPGLs patients who underwent laparoscopic or robotic-assisted surgeries were included. Univariate and multivariate logistic regression (LR) analyses were conducted to identify the independent risk factors for HI. Various ML methods were employed to construct predictive models, including random forest (RF) and support vector machine (SVM). The receiver operating characteristic (ROC) curves, decision curve analysis (DCA), calibration curve, and Hosmer-Lemeshow test were employed to assess the performance of the ML models. The SHapley Additive explanation (SHAP) method was used to explain the model by prioritizing feature importance based on their contribution to the prediction.</p><p><strong>Results: </strong>The univariate and multivariate analyses revealed that the white blood cell-to-lymphocyte ratio (WLR), neutrophil-to-platelet Ratio (NPR), international normalized ratio (INR), and other clinical parameters were independent risk factors for HI (P < 0.05). The RF model exhibited the best predictive performance, with an AUC of 0.854 on the training set and 0.812 on the test set. The calibration plot and Hosmer-Lemeshow test showed the model had excellent concordance. DCA demonstrated that the predictive model was clinically practical and effective. The SHAP method identified WLR as the most critical factor contributing to the prediction.</p><p><strong>Conclusion: </strong>In patients with hypertensive PPGLs, inflammatory, coagulation, and other clinical parameters are correlated with a high risk of intraoperative HI. ML models have a good predictive ability for HI in patients with sustained hypertensive PPGLs.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"555"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070594","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":"Algorithm to detect ISUP ≥ 2 prostate cancer using canine detection.","authors":"Margaux Hermieu, Alice Roux, Loïc Desquilbet, Nicolas Hermieu, Capucine Gallet, Evanguelos Xylinas, Alexandre de La Taille, Dominique Grandjean, Jean-François Hermieu","doi":"10.1007/s00345-025-05938-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05938-1","url":null,"abstract":"<p><strong>Purpose: </strong>Screening and diagnosing ISUP ≥ 2 prostate cancer is challenging. This study aimed to determine whether canine detection could be beneficial addition to the ISUP ≥ 2 prostate cancer diagnostic protocol by creating a decision-making algorithm for men with suspected prostate cancer.</p><p><strong>Methods: </strong>We conducted a prospective study at two urology institutions and a French veterinary school, including men with a suspicion of prostate cancer from November to April 2023, which were divided into two groups according to their prostate biopsy results. Eight binary variables known to be associated with a higher risk of prostate cancer were considered: body mass index, family history, age, smoking status, hypertension, digital rectal examination, _total PSA level and prostate MRI. A decision-making algorithm was then created using two diagnostic scores.</p><p><strong>Results: </strong>151 patients were included, 78 with ISUP ≥2 prostate cancer, and 73 without. The ProstateDetectScore was based on age, blood pressure, digital rectal examination, and MRI.[Formula: see text]Weight _i is the whole part {rounded (10 x β _i)} where β _i is the model parameter value associated with the variable i included in this model and var _ij is the value of variable i for patient j. The ProstateK9DetectScore is calculated from the same data plus the canine detection result. The following algorithm was constructed: PCa Prostate cancer, NPV negative predictive value, PPV positive predictive value CONCLUSION: The algorithm, involving canine detection, increases ISUP ≥2 prostate cancer detection rate through prostate biopsy, thus reducing the number of unnecessary biopsies.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"549"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034249","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 \"PSA density correlates to pathology T stage and ISUP grade: insights from a cohort of 3568 radical rostatectomy cases\".","authors":"Mohammad Taha Rahimipour, Ali Sedighi, Nima Masoudi","doi":"10.1007/s00345-025-05934-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05934-5","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"551"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034241","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}