Urology Practice最新文献_第10页

When the Knife Cuts Both Ways: The Emotional Toll From Surgical Complications on Urologists in Training and in Practice. 当手术刀双向切割：泌尿外科医生在培训和实践中手术并发症的情绪损失。

IF 1.6

Urology Practice Pub Date : 2026-08-06 DOI: 10.1097/UPJ.0000000000001069

Thomas Kozar, Yana Feygin, Kimberly Toumazos, Campbell Grant

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Letter: Incarcerated Patients Present With More Advanced Bladder Cancer Stage: A Statewide Analysis. 信函：监禁患者呈现更晚期膀胱癌阶段：一项全州范围的分析。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-03-16 DOI: 10.1097/UPJ.0000000000000987

Melissa Assel, Andrew J Vickers

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Risk Factors for Fluoroquinolone Resistance on Pre-Prostate Biopsy Rectal Swab. 前列腺活检前直肠拭子对氟喹诺酮类药物耐药的危险因素

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-02-13 DOI: 10.1097/UPJ.0000000000000985

Conor B Driscoll, Mitchell M Huang, Nicole Handa, Evan J Panken, Yutai Li, Edward M Schaeffer, Anthony J Schaeffer, Teresa R Zembower

{"title":"Risk Factors for Fluoroquinolone Resistance on Pre-Prostate Biopsy Rectal Swab.","authors":"Conor B Driscoll, Mitchell M Huang, Nicole Handa, Evan J Panken, Yutai Li, Edward M Schaeffer, Anthony J Schaeffer, Teresa R Zembower","doi":"10.1097/UPJ.0000000000000985","DOIUrl":"10.1097/UPJ.0000000000000985","url":null,"abstract":"Introduction: Prostate cancer (PCa) is usually diagnosed through transrectal prostate needle biopsy (PNB). Targeted prophylaxis with pre-PNB rectal swab and tailored antibiotics, often fluoroquinolones, can decrease post-PNB urosepsis risk, but fluoroquinolone resistance (FQR) is rising. The 2016 AUA white paper discusses risk factors for post-PNB sepsis, but more contemporary evidence is needed. Here, we evaluated FQR rate across a multihospital system and identify FQR risk factors.Methods: We report a retrospective cohort study of patients who underwent pre-PNB rectal swab between 2013 and 2024 across a multihospital health system. The Northwestern Enterprise Data Warehouse was used to identify patients who underwent pre-PNB rectal swab and to capture demographic, comorbidity, and encounter data. The primary outcome was FQR trend over time, and the secondary outcome was to identify FQR risk factors.Results: In total, 10,372 patients underwent pre-PNB rectal swabs from 2013 to 2024, and 1952 (18.8%) had FQR with Escherichia coli as 95.5% of the resistant bacteria. FQR rates remained stable between 2013 and 2024. On multivariable regression, age, uninsured status, Hispanic ethnicity, Asian race, Black race, prior diverticulitis, and any prior fluoroquinolone exposure were associated with increased risk of rectal FQR. Former smoking status and prior colonoscopy were associated with a decreased risk of rectal FQR. County-level analysis revealed no county-level factors associated with rectal FQR.Conclusions: We identified novel patient-level FQR risk factors including any fluoroquinolone exposure, age, uninsured status, Hispanic ethnicity, non-White race, and prior diverticulitis. The current AUA guidance regarding FQR may not provide sufficient detail for comprehensive pre-PNB counseling, suggesting need for further refinement.","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"413-421"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Editorial Commentary. 编辑评论。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-03-17 DOI: 10.1097/UPJ.0000000000000991

Stephen Sekoulopoulos, Joseph Y Clark

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Editorial Comment. 编辑评论。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-04-09 DOI: 10.1097/UPJ.0000000000000999

Dhiraj S Bal, Premal Patel

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Editorial Commentary. 编辑评论。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-04-09 DOI: 10.1097/UPJ.0000000000001003

Trevor C Hunt, Matthew Steidle, Jathin Bandari

引用次数: 0

Adjuvant PD-1 Inhibitors After Radical Surgery for High-Risk Muscle-Invasive Urothelial Carcinoma: A Systematic Review and Meta-Analysis of Phase 3 Trials. 高危肌浸润性尿路上皮癌根治性手术后PD-1辅助抑制剂：III期试验的系统回顾和荟萃分析

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-02-10 DOI: 10.1097/UPJ.0000000000000984

Wala Ben Kridis, Afef Khanfir

{"title":"Adjuvant PD-1 Inhibitors After Radical Surgery for High-Risk Muscle-Invasive Urothelial Carcinoma: A Systematic Review and Meta-Analysis of Phase 3 Trials.","authors":"Wala Ben Kridis, Afef Khanfir","doi":"10.1097/UPJ.0000000000000984","DOIUrl":"10.1097/UPJ.0000000000000984","url":null,"abstract":"Introduction: Patients with high-risk muscle-invasive bladder cancer (MIBC) remain at substantial risk of disease recurrence. Randomized phase 3 trials have evaluated adjuvant programmed cell death 1 (PD-1) inhibitors in this setting, but the magnitude and consistency of benefit across patient subgroups remain incompletely defined.Methods: We performed a systematic review and meta-analysis of randomized phase 3 trials comparing adjuvant PD-1 inhibitors with placebo or observation in patients with resected high-risk MIBC. HRs for disease-free survival (DFS) and overall survival (OS), as well as risk ratios for adverse events, were pooled using random-effects models. Prespecified subgroup analyses were conducted according to PD-L1 (programmed death-ligand 1) expression and prior receipt of cisplatin-based neoadjuvant chemotherapy.Results: Two phase 3 trials encompassing patients treated with adjuvant nivolumab or pembrolizumab were included. Adjuvant PD-1 inhibitor therapy significantly improved DFS compared with control (pooled HR <1), with consistent benefit observed across PD-L1-defined subgroups and regardless of prior neoadjuvant cisplatin use. A favorable trend toward improved OS was observed, although survival data remain immature. Treatment was associated with a higher incidence of grade 3 or higher and immune-related adverse events compared with placebo or observation.Conclusions: Among patients with resected high-risk MIBC, adjuvant PD-1 inhibitor therapy significantly improves DFS with an acceptable safety profile. However, owing to the limited number of studies and short follow-up periods, these findings should be considered preliminary, and longer follow-up is required to confirm any potential OS benefit.","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"450-458"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Medicaid Expansion on Insurance Coverage and Metastatic Disease at Diagnosis for Racial and Ethnic Subgroups Diagnosed With Prostate Cancer. 医疗补助扩大对诊断为前列腺癌的种族和民族亚群的保险覆盖范围和转移性疾病的影响。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-02-17 DOI: 10.1097/UPJ.0000000000000986

David Schroeder, Solange Bassale, Murray J Bartho, Vanessa Le, Brian Duty, Ryan P Kopp

{"title":"The Impact of Medicaid Expansion on Insurance Coverage and Metastatic Disease at Diagnosis for Racial and Ethnic Subgroups Diagnosed With Prostate Cancer.","authors":"David Schroeder, Solange Bassale, Murray J Bartho, Vanessa Le, Brian Duty, Ryan P Kopp","doi":"10.1097/UPJ.0000000000000986","DOIUrl":"10.1097/UPJ.0000000000000986","url":null,"abstract":"Introduction: Improved access to health care following the Affordable Care Act's Medicaid expansion may affect prostate cancer (PCa) disease course. We hypothesized that Medicaid expansion states (ESs) experienced greater Medicaid coverage gains and lower proportions of metastatic disease at the time of detection.Methods: We analyzed 1.02 million patients aged 40 to 64 years diagnosed with PCa from 2004 to 2022 using the National Cancer Database. We generated descriptive statistics on demographic variables and divided patients into groups using diagnosis date (pre expansion and post expansion) and state expansion status (ES and nonexpansion state [NES]). Multivariate logistic regression analysis was performed to determine the impact of expansion status and demographics on Medicaid enrollment and metastatic disease at diagnosis.Results: In pre-expansion years, the percentage of Medicaid patients in ESs and NESs was 3.5% vs 2.5%, respectively. After expansion, Medicaid patient percentage rose in ESs (9.5%, +6.0%) and NESs (4.4%, +1.9%). Pre expansion, the odds of being enrolled in Medicaid was 3.01 times higher for Black patients than White patients, which declined to 2.62 after expansion. The odds of being enrolled in Medicaid for those in ESs vs NESs rose from 1.80 to 2.94 after expansion. The odds ratio (OR) of presenting with metastatic disease among Medicaid patients in NESs (OR 4.11) was 1.37 times higher (95% CI 1.29-1.45, P < .0001) than Medicaid patients in ESs (OR 3.00).Conclusions: Medicaid expansion provided coverage gains through Medicaid for PCa patients, who also had lower odds of metastatic disease at diagnosis.","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"375-384"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Reply by Authors. 作者回复。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-04-01 DOI: 10.1097/UPJ.0000000000000992

David Schroeder, Solange Bassale, Murray J Bartho, Vanessa Le, Brian Duty, Ryan P Kopp

引用次数: 0

Ten-Year Experience Transitioning from Magnetic Resonance Imaging-Guided Transrectal to Transperineal Prostate Biopsies at a Large Single-Institution Academic Center. 在一个大型单一机构学术中心，从mri引导的经直肠前列腺活检到经会阴前列腺活检的十年经验。

IF 1.6

Urology Practice Pub Date : 2026-07-01 Epub Date: 2026-03-31 DOI: 10.1097/UPJ.0000000000000988

Chris Du, Rohan Sethi, Timothy M Han, Nicholas Lanzotti, Dana Alhusseini, Julia Hall, Jessica Helon, Joseph Saba, Ushasi Naha, Maitri Mehta, Sung Alexander, Mallory McCormick, Loren Roustio, Marcus L Quek, Michael E Woods, Alex Gorbonos, Robert C Flanigan, Steven Shea, Maria Picken, Güliz A Barkan, Gopal N Gupta

{"title":"Ten-Year Experience Transitioning from Magnetic Resonance Imaging-Guided Transrectal to Transperineal Prostate Biopsies at a Large Single-Institution Academic Center.","authors":"Chris Du, Rohan Sethi, Timothy M Han, Nicholas Lanzotti, Dana Alhusseini, Julia Hall, Jessica Helon, Joseph Saba, Ushasi Naha, Maitri Mehta, Sung Alexander, Mallory McCormick, Loren Roustio, Marcus L Quek, Michael E Woods, Alex Gorbonos, Robert C Flanigan, Steven Shea, Maria Picken, Güliz A Barkan, Gopal N Gupta","doi":"10.1097/UPJ.0000000000000988","DOIUrl":"10.1097/UPJ.0000000000000988","url":null,"abstract":"Introduction: We share our 10-year experience with transitioning from MRI-fusion transrectal (TR) to MRI-fusion transperineal (TP) prostate biopsy and the increased costs and time associated with this transition, particularly from the pathology perspective.Methods: Our prospectively maintained MRI-fusion prostate biopsy database was queried. Demographic and clinical data were captured. The cost difference between processing TR and TP biopsies was calculated. Scenarios to decrease cost and time were explored. R-software was used for statistical analyses.Results: Over 10 years, 2370 prostate biopsies were performed (1719 TR, 651 TP). TP biopsy became the preferred method in 2023. The overall cancer detection rates (CDRs) and clinically significant CDRs (csCDRs) for TR biopsy were 55.4% (952/1719) and 35.4% (609/1719), respectively. For TP, it was 62.8% (409/651) and 41.8% (272/651), respectively. This was a significant difference in CDRs and csCDRs (P < .01). The estimated increased annual cost for TP biopsy from a pathology processing standpoint was $136,662, and the estimated time increase per year was 1332.5 hours. We constructed 4 scenarios with cost and time reductions as high as $282,750 and 2730 hours per year, respectively.Conclusions: Transitioning to an MRI-fusion TP prostate biopsy has resulted in higher overall CDRs and csCDRs but also significantly higher costs and time spent. Possible designs may exist that could yield significant cost and time savings per annum.","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"350-357"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0