World Journal of Urology最新文献

{"title":"Comparing the clinical outcomes and learning curves of prostatic urethral lift performed by experienced versus naïve urologists.","authors":"Tsung-Yi Hsieh, Jian-Hua Hong, Jeff Shih-Chieh Chueh","doi":"10.1007/s00345-025-05895-9","DOIUrl":"10.1007/s00345-025-05895-9","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the learning process by comparing the clinical outcomes and learning curves of prostatic urethral lift (PUL) performed by experienced versus naïve urologists.</p><p><strong>Methods: </strong>Consecutive patients treated with PUL at a tertiary center by an experienced urologist with > 100 PUL cases or by naïve urologists with no prior PUL experience were included in this study. Perioperative parameters, functional outcomes, complications, and retreatment rates were compared. Learning curves were assessed using the cumulative sum (CUSUM) methodology. Multivariate regression identified predictors of operative time.</p><p><strong>Results: </strong>The median operative time was 20.0 min in both groups. Overall, the International Prostate Symptoms Score total decreased by a median of 9.0 points, quality of life score decreased by a median of 2.0 points, peak urinary flow rate increased by a median of 4.3 ml/sec, and post-void residual volume decreased by a median of 19.8 ml. There were no significant differences between the two groups in functional outcomes, complication rate, or operative time. CUSUM analysis revealed a three-phase learning curve, with proficiency achieved after 5 to 8 cases. Operative time was independently associated with obstructive median lobe (P = 0.003), number of implants (P = 0.005), implant deployment failure (P < 0.001), and experience (P = 0.024).</p><p><strong>Conclusion: </strong>PUL can be safely and effectively performed by both experienced and naïve urologists with comparable outcomes. The learning curve is short but defined with proficiency achieved after 5 to 8 cases.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"532"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971701","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":"Letter to the editor: \"bladder cancer isn't BPH: why TURBT patients deserve separate risk models for complicated UTI\".","authors":"Zhiyu Shi, Zongyan Luo, Wei Luo, Bin Zhao","doi":"10.1007/s00345-025-05883-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05883-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"527"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971708","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":"War-related urological trauma in Israel: a retrospective national registry analysis.","authors":"Husny Mahmud, Yoram Mor, Adi Givon, Noam Kitrey","doi":"10.1007/s00345-025-05899-5","DOIUrl":"10.1007/s00345-025-05899-5","url":null,"abstract":"<p><strong>Background: </strong>Urological trauma significantly affects patient morbidity, functional outcomes, and healthcare resource utilization. This study evaluated war-related genitourinary (GU) injuries that occurred during the Israeli-Gaza War, with a focus on injury patterns, management, and clinical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective analysis utilizing the Israeli National Trauma Registry, which is managed by the Gertner Institute for Health Policy and Epidemiology. This registry captures data on all of the patients admitted to trauma centers in Israel. Data quality is maintained through ongoing training of data abstractors and regular audits of registry data. All documented hospitalizations from October 7, 2023, to May 31, 2024, were included, excluding noncombat-related injuries. GU injuries were classified by anatomical location into the upper urinary tract (kidney/ureter), lower urinary tract (bladder/urethra), and external genitalia (penis/scrotum/testes). The data collected included demographics, injury mechanisms, injury severity score (ISS), surgical management, and clinical outcomes (ICU admissions, hospital length of stay [LOS], rehabilitation needs, and mortality). GU patients were compared with non-GU patients.</p><p><strong>Results: </strong>Of the 2,422 total casualties, 117 (4.8%) sustained GU injuries. The mean age was 27.2 ± 9.2 years (range 14-76) in the GU-injured casualty group versus 30.1 ± 15.1 years (range 0-97) in the non-GU casualty group; the difference was not significant (p = 0.43), with 97.4% males. Explosive devices (59.0%) and gunshot wounds (36.8%) were the predominant injury mechanisms. Severe injuries (ISS ≥ 16) occurred significantly more frequently among GU-injured patients (61.5% vs. 21.6%, p < 0.0001). External genital injuries were the most common injuries (60.7%), followed by kidney (27.4%) and bladder damage (10.3%). Associated pelvic fractures occurred in 18% of the GU trauma patients versus 1.8% of the non-GU-injured patients (p < 0.0001). Surgical interventions were performed in 84.6% of the patients, among whom scrotal/testicular surgeries (27.4%) were most common. ICU admissions (44.4%), prolonged hospitalizations ≥ 14 days (41.4%), rehabilitation needs (53.0%), and mortality (6.8%) were significantly greater among GU-injured patients.</p><p><strong>Conclusions: </strong>War-related GU trauma, although relatively uncommon, involves severe injuries, extensive surgical management, prolonged hospitalizations, and substantial rehabilitation demands. Enhancements in protective equipment and multidisciplinary treatment strategies are critical for optimizing outcomes in future conflicts.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"528"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971471","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":"Renal arterial pseudoaneurysm after robotic-assisted partial nephrectomy: a single-center analysis.","authors":"Yu-Pin Huang, Hsiao-Jen Chung, I-Shen Huang, Tzu-Ping Lin, Shing-Hwa Lu, Eric Y H Huang","doi":"10.1007/s00345-025-05851-7","DOIUrl":"10.1007/s00345-025-05851-7","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the incidence of renal artery pseudoaneurysm (RAP) after robotic-assisted partial nephrectomy (RaPN), identify predictive factors, and evaluate endovascular management.</p><p><strong>Methods: </strong>The institutional RaPN database was retrospectively reviewed, and data from December 2009 to June 2021 were used. Computed tomography angiography was used to diagnose RAP. Patients who underwent embolization for RAP after RaPN were compared with those without RAP or with RAP managed conservatively. Data on patient demographics, tumor characteristics, and operative outcomes were evaluated, and the predictive factors for RAP after RaPN were determined.</p><p><strong>Results: </strong>Of the 544 patients who underwent RaPN, 14 developed RAP after surgery, of which 12 underwent embolization. Most patients experienced gross hematuria and were diagnosed using computed tomography angiography. No patient exhibited recurrent RAP during follow-up. The following was found for patients who underwent embolization for RAP: a higher proportion of men (91.7% vs. 59.4%, p = 0.024), higher RENAL nephrometry scores (median: 9.0 vs. 8.0, p = 0.02), longer operative times (mean: 349.6 vs. 283.7 min, p = 0.046), and longer postoperative hospital stays (median: 6.0 vs. 5.0 days, p = 0.031). The N score in the RENAL nephrometry score was significantly higher in the embolization group (p = 0.031) than in the nonembolization group. Univariate analysis revealed that RENAL nephrometry scores and total operative time were significant predictors of RAP occurrence.</p><p><strong>Conclusion: </strong>The occurrence of RAP was associated with higher RENAL nephrometry scores and longer operative times.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"526"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971826","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":"Safety and efficacy of Pharmacologic thromboprophylaxis following percutaneous nephrolithotomy: a retrospective cohort study.","authors":"Behnam Shakiba, Nasim Torabi, Robab Maghsoudi, Vahid Vahedi, Mohammadreza Padooiy Nooshabadi, Ali Faegh","doi":"10.1007/s00345-025-05905-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05905-w","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is the standard treatment for large or complex renal stones; however, it carries risks such as bleeding and venous thromboembolism (VTE). Current guidelines do not recommend routine pharmacologic thromboprophylaxis in these patients due to concerns about bleeding and limited supporting evidence. This study evaluates the safety and efficacy of unfractionated heparin thromboprophylaxis in patients at moderate to high VTE risk undergoing PCNL.</p><p><strong>Methods: </strong>In this retrospective cohort study, 202 patients undergoing PCNL were assigned to either heparin prophylaxis (n = 79) or early ambulation without pharmacologic prophylaxis (n = 123). Baseline demographics, stone characteristics, operative parameters, and postoperative outcomes-including bleeding, transfusion, complications, hemoglobin drop, and thromboembolic events were compared.</p><p><strong>Results: </strong>Patients receiving heparin were older (55.1 vs. 44.5 years, p < 0.001) and had higher BMI (median 28.9 vs. 26.5 kg/m², p = 0.001). No significant differences were observed in stone size, location, surgery duration, hemoglobin drop, transfusion rates, or overall complications. Access tract length was slightly longer in the heparin group (p = 0.028). Thromboembolic events were rare and did not differ significantly between groups (p = 0.282). Notably, in the early ambulation group, one patient experienced deep vein thrombosis and two developed pulmonary thromboembolism (one fatal).</p><p><strong>Conclusions: </strong>Pharmacologic thromboprophylaxis with unfractionated heparin after PCNL appears safe without increased bleeding risk. While our findings suggest a potential benefit in reducing thromboembolic events in moderate- to high-risk patients, the limited sample size and retrospective design preclude definitive conclusions.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"525"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971819","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":"World-wide variation in percutaneous nephrolithotomy practices: evaluation based on training, experience, and region.","authors":"Kavita Gupta, Ziv Savin, Dara Lundon, Christopher Connors, Juan Serna, Anna Ricapito, Raymond Khargi, Roman Shimonov, Alan J Yaghoubian, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1007/s00345-025-05901-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05901-0","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous nephrolithotomy (PCNL) has undergone numerous technological innovations recently that make it even less invasive, but global adoption of these innovations remains unclear. This study sought to compare the effect of region and education on the penetrance of recent advances in PCNL worldwide.</p><p><strong>Methods: </strong>An anonymous 32-item survey was developed and distributed via the Endourological Society's Twitter/X account in November 2023. The survey collected data on participants' geographic region, PCNL volume, fellowship training, and PCNL practices. Descriptive statistics were calculated, and chi-square or Fisher's exact tests were used for comparisons.</p><p><strong>Results: </strong>Responses were received from 160 PCNL providers worldwide. Respondents were categorized by geography, fellowship training, and procedural volume. Spinal anesthesia was more commonly used by Asian providers (31%, p = 0.001), while supine positioning was notably more common in Europe (76%, p = 0.001). Asian providers favored pneumatic energy (63%), while North American and European providers more frequently used dual energy lithotripters (31-72%) and hemostatic tract agents (p < 0.001). High-volume providers and those with more post-fellowship experience tended to use smaller sheaths, including mini-PCNL. Postoperative imaging practices also varied by region and fellowship-training status.</p><p><strong>Conclusion: </strong>PCNL practices vary significantly worldwide, influenced by regional, economic, and experiential factors. Our survey indicates a significant shift in practices with 41% of providers using supine position and over 50% doing tubeless PCNL. However, ultrasound access has been slow to gain widespread use with 73% still using predominantly fluoroscopy, similar to prior studies. Further randomized studies are needed to establish the clinical effectiveness of new technologies and to drive standardization of care across geographic and economic barriers.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"523"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971507","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 effect of chronic kidney disease on adverse in-hospital outcomes after partial nephrectomy.","authors":"Calogero Catanzaro, Fabian Falkenbach, Andrea Marmiroli, Mattia Longoni, Quynh Chi Le, Michele Nicolazzini, Federico Polverino, Jordan A Goyal, Lorenzo Bianchi, Pietro Piazza, Matteo Droghetti, Fred Saad, Shahrokh F Shariat, Markus Graefen, Matteo Ferro, Alberto Briganti, Felix K H Chun, Alessandro Volpe, Nicola Longo, Riccardo Schiavina, Pierre I Karakiewicz","doi":"10.1007/s00345-025-05892-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05892-y","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"524"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971778","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":"TROP-2 overexpression in papillary renal cell carcinoma supports its potential as a therapeutic target for antibody-drug-conjugate therapy.","authors":"Carolina Kessler, Melanie von Brandenstein, Niklas Klümper, Philipp Krausewitz, Enno Storz, Constantin Rieger, Laurenz Sperber, Pia Paffenholz, Yuri Tolkach, Ralph Wirtz, Markus Eckstein, Axel Heidenreich, Richard Weiten","doi":"10.1007/s00345-025-05880-2","DOIUrl":"10.1007/s00345-025-05880-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"522"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971840","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":"Dermatological impacts of urological cancer treatments.","authors":"Alejandra Sataray-Rodriguez, Damilola Oladinni, Robert Adler, Natasha Doshi, Bailey Patrick, Nicole Aust, Michael Sun, Nina Schur, Scott Jamieson, Jeffrey P Weiss","doi":"10.1007/s00345-025-05896-8","DOIUrl":"10.1007/s00345-025-05896-8","url":null,"abstract":"<p><p>Urological cancers-including prostate, bladder, renal, and testicular cancers-are commonly treated with surgery, chemotherapy, radiation therapy, and immunotherapy. While these therapies improve survival outcomes, they often induce significant dermatological side effects that impair patients' quality of life and treatment adherence. This review synthesizes current literature on the prevalence, mechanisms, and psychosocial consequences of dermatological toxicities associated with urological cancer treatments. Common adverse effects include dermatitis, alopecia, photosensitivity, hyperpigmentation, and scarring, with severity varying by treatment modality. Chemotherapy frequently causes alopecia and hand-foot syndrome, while radiation therapy leads to dermatitis and long-term fibrosis. Immunotherapy, though revolutionary, is associated with pruritus, vitiligo, and severe cutaneous reactions such as Stevens-Johnson syndrome. The psychosocial burden of these dermatological effects-particularly impacts on body image and self-esteem-is substantial yet understudied. Multidisciplinary management strategies, including early dermatological intervention, patient education, and psychosocial support, are essential to mitigate these effects. Future research should focus on standardized protocols, personalized treatment approaches, and improved patient-reported outcome measures to optimize holistic cancer care.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"521"},"PeriodicalIF":2.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971740","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":"Neurovascular bundle preservation improves postoperative continence recovery in robotic-assisted laparoscopic radical prostatectomy after neoadjuvant hormonal therapy in the treatment of locally advanced prostate cancer: results from a propensity score-matched analysis.","authors":"Ming Yang, Tianxiao Hong, Hao Ji, Chaoran Zhao, Yamin Wang, Shangqian Wang, Meiling Bao, Pengchao Li","doi":"10.1007/s00345-025-05794-z","DOIUrl":"10.1007/s00345-025-05794-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the oncological outcomes and continence recovery of neoadjuvant hormonal therapy (NHT) before robot-assisted laparoscopic radical prostatectomy (RARP) with neurovascular bundle (NVB) preservation in patients with locally advanced prostate cancer (LAPC).</p><p><strong>Methods: </strong>Of the 576 patients with LAPC who underwent RARP during January 2016-March 2024, those who received NHT before RARP with NVB preservation (NVB-RARP) were propensity score (PS)-matched with those undergoing RARP without NVB preservation (NNVB-RARP) based on preoperative and histological characteristics. Clinical and biochemical recurrence results were evaluated post-surgically, and postoperative continence was analyzed in the two groups using Kaplan-Meier curves.</p><p><strong>Results: </strong>After PS matching, each group was matched with 77 patients. When compared with the NNVB-RARP group, the NVB-RARP group did not show any significant difference in the operation time (102.72 ± 11.64 min vs.105.05 ± 16.73 min, p = 0.319), postoperative hospitalization time (5.01 ± 0.80 d vs. 5.21 ± 1.13 d, p = 0.248), intraoperative bleeding (158.43 ± 13.76 mL vs. 161.23 ± 15.15 mL, p = 0.232), pathologic tumor stage (≤ pT2) (53.25% vs. 50.65%, p = 0.747), lymph node status (N1) (27.27% vs. 36.36%, p = 0.226), pathological Gleason score (≥ 8) (81.82% vs. 76.62%, p = 0.427), positive surgical margin (15.58% vs. 20.78%, p = 0.403), or complications (9.10% vs.11.69%, p = 0.597). The NVB-RARP group demonstrated significantly faster continence recovery than the NNVB-RARP group (recovery rates: 1 month 42.86% vs. 16.88%, p < 0.001, 3 months 62.34% vs. 36.36%, p = 0.001, and 12 months 83.12% vs. 66.23%, p = 0.016).</p><p><strong>Conclusion: </strong>The present findings suggest that NHT before RARP with NVB preservation may enhance continence recovery without compromising the oncological outcomes in patients with LAPC.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"520"},"PeriodicalIF":2.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971735","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}