Urology Practice最新文献

{"title":"Editorial Commentary.","authors":"Brian D Cortese, Ruchika Talwar","doi":"10.1097/UPJ.0000000000001071","DOIUrl":"10.1097/UPJ.0000000000001071","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"578"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907648","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}

{"title":"Patient Trust and Medical Mistrust Toward Overactive Bladder Therapies: General Consumer Awareness and Perceptions.","authors":"Lucia Martinez-Sanchez, Annie Chen, Laura Oscar-Thompson, Nivetha Chandrasekaran, Kathleen Kobashi, Ricardo R Gonzalez","doi":"10.1097/UPJ.0000000000001049","DOIUrl":"10.1097/UPJ.0000000000001049","url":null,"abstract":"<p><strong>Introduction: </strong>Overactive bladder (OAB) is a prevalent condition associated with impaired quality of life, yet many patients do not pursue treatment or minimally invasive therapies (MITs). Physician-patient concordance has been proposed as a factor influencing trust, although its role in OAB care is not well defined. We evaluated the association between physician gender concordance and patient trust, and examined the relationship of trust with health literacy, medical mistrust, and treatment preferences for OAB among broad US consumers.</p><p><strong>Methods: </strong>In this survey-based study, Black and White women were randomized to view one of 4 standardized videos describing OAB treatments, differing only by physician race and gender. Trust was dichotomized from a 4-point Likert scale. Participants reported treatment preferences and completed the eHealth Literacy Scale and Group-Based Medical Mistrust Scale. Associations were assessed using chi-square tests and multivariable logistic regressions.</p><p><strong>Results: </strong>Among 1027 participants, physician gender concordance was not associated with trust (<i>P</i> >.05). Trust was strongly associated with both OAB diagnosis (<i>P</i> = .001) and selection of MITs (<i>P</i> < .001). Higher eHealth literacy independently increased the odds of trust (odds ratio 1.06, <i>P</i> < .001), whereas greater medical mistrust reduced the odds (odds ratio 0.94, <i>P</i> < .001). Income was also independently associated with trust. Race was not an independent predictor, although Black participants reported significantly higher medical mistrust.</p><p><strong>Conclusions: </strong>Greater patient trust increased likelihood of having an OAB diagnosis and selection of MITs. Health literacy and medical mistrust demonstrated stronger associations with trust than physician gender concordance, highlighting potential areas for improving patient engagement in OAB care.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"679-685"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346770","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}

{"title":"The Role of Veterans Affairs Rotations in Urology Residency Training: Insights From a Society of Academic Urologists Survey.","authors":"Eric S Giannaris, Frances Kazal, Mark Cogburn, Maximiliano Sorbellini, Gina M Badalato","doi":"10.1097/UPJ.0000000000001048","DOIUrl":"10.1097/UPJ.0000000000001048","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"561-564"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319837","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}

{"title":"Editorial Commentary.","authors":"Kendrick Yim, Jeffrey L Ellis","doi":"10.1097/UPJ.0000000000001046","DOIUrl":"10.1097/UPJ.0000000000001046","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"604"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425256","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}

{"title":"Adjuvant Radiation Therapy vs Initial Observation for Patients After Prostatectomy With Adverse Pathology: Have Findings From 3 Randomized Clinical Trials Influenced Clinical Practice?","authors":"Timothy Demus, Kevin B Ginsburg, Sabir Meah, Stephanie Daignault-Newton, Corinne Labardee, Anna Johnson, Jason Hafron, James Peabody, Robert Dess, Todd Morgan, Alice Semerjian, Tudor Borza, Richard Sarle","doi":"10.1097/UPJ.0000000000001055","DOIUrl":"10.1097/UPJ.0000000000001055","url":null,"abstract":"<p><strong>Introduction: </strong>Results from 3 randomized clinical trials (RCTs) established initial observation with early salvage radiotherapy as the standard of care for men with adverse pathology after radical prostatectomy (RP). The aim of our study was to assess whether the use of adjuvant radiotherapy (aRT) has declined since the 2020 publication of these RCTs.</p><p><strong>Methods: </strong>We retrospectively reviewed the Michigan Urological Surgery Improvement Collaborative prostate cancer registry and identified men who underwent RP from 2012 to 2024 and approximated the inclusion criteria of the RCTs: postoperative PSA ≤ 0.1 ng/mL and at least 1 pathological feature (pT3a, pT3b, pT4, or positive surgical margins). The primary objective was to test the association of time period of RP (before 2020 vs 2020 vs after 2020) with the use of aRT vs initial observation. aRT was defined as radiation therapy that was started both within 12 months of diagnosis and with PSA ≤ 0.1 ng/mL. The Kaplan-Meier method and mixed-effects multivariable Cox regression were used to evaluate an association of time period with aRT.</p><p><strong>Results: </strong>Of 9144 patients meeting inclusion criteria, 5408 had RP before 2020, 764 in 2020, and 2972 after 2020. Before 2020, 8.2% of patients (95% CI: 7.5%-9.0%) were treated with aRT, compared with 4.6% (95% CI: 3.2%-6.4%) in 2020 and 2.7% (95% CI: 2.1%-3.5%) after 2020. After adjustment in the multivariable model, patients undergoing RP after compared with before 2020 were less likely to receive aRT (odds ratio 0.24, 95% CI: 0.18-0.32, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>The use of aRT decreased after 2020, consistent with level 1 evidence supporting initial observation in patients with adverse pathology.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"653-662"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377506","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}

{"title":"Association of Fertility Preservation Benefit Mandates With Sperm Bank Network Adequacy: A Mixed-Methods Study.","authors":"Jonathan H Berger, Sara W Yoeun, Ricardo E Flores Ortega, Bonnie N Kaiser, Kristina Nguyen, Victoria Turcotte, Natasha Bisarya, H Irene Su, Sara B McMenamin","doi":"10.1097/UPJ.0000000000001039","DOIUrl":"10.1097/UPJ.0000000000001039","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of states mandating insurance coverage of fertility preservation for those facing iatrogenic infertility is unclear. We sought to qualitatively understand barriers to clinic acceptance of insurance coverage for sperm banking fertility preservation services and quantitatively estimate the association between mandated fertility benefits and clinics accepting insurance.</p><p><strong>Methods: </strong>Staff at sperm banks in 3 mandate states completed in-depth interviews regarding patients accessing fertility preservation benefits through their insurance. Recruitment stopped at information saturation. Subsequently, a United States-wide secret shopper study was completed of andrology/fertility clinics evaluating acceptance of insurance for sperm freezing services and cash costs of services for a fictitious male patient with cancer.</p><p><strong>Results: </strong>Seven interviews provided 4 dominant themes to describe clinic experience in mandated states: (1) coverage gaps/low reimbursement for sperm banking services, (2) clinic resources needed to navigate insurance, (3) prior authorization care delays, and (4) need for sperm banks to educate patients and insurers on mandates. In total, 200 of 418 clinics (56%) answered the secret shopper survey, with a majority (69.5%, n = 153) offering sperm banking services. Only 36.9% of these accepted insurance, with clinics in mandate states being more likely to accept insurance than in nonmandate states (61.0% vs 27.8%, <i>P</i> value = .0002). Only 37 (24.5%) of the clinics provided cash cost of sperm banking (ranging from $50 to $2000).</p><p><strong>Conclusions: </strong>The intent of fertility preservation mandates may be limited by barriers at insurer and clinic levels. Strategies to overcome barriers are needed to improve access to the full scope of fertility preservation benefits for male patients with cancer.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"588-594"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319756","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}

{"title":"Reply by Authors.","authors":"Fortis Gaba, Adrian J Waisman Malaret, Paul J Feustel, Badar M Mian","doi":"10.1097/UPJ.0000000000001050","DOIUrl":"10.1097/UPJ.0000000000001050","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"651-652"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537046","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}

{"title":"Reply by Authors.","authors":"Johnny Wang, Hannah Cho, Eric Kim, Mohammad Shahait, David Lee","doi":"10.1097/UPJ.0000000000001060","DOIUrl":"10.1097/UPJ.0000000000001060","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"622"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680347","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}

{"title":"Factors Associated With Hematuria Resolution and Hematuria Admissions After Hyperbaric Oxygen Therapy for Chronic Radiation Cystitis.","authors":"Allison G Booher, Kathryn E McGonagle, Janet L Peacock, Elaine M Silverman, Pamela M Hannigan, Lawrence C Bornt, William Bihrle, Jay C Buckey, Rachel A Moses","doi":"10.1097/UPJ.0000000000001041","DOIUrl":"10.1097/UPJ.0000000000001041","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen therapy (HBO₂) reduces chronic radiation cystitis (RC) bladder bleeding events; however, the time course of hematuria resolution and frequency of posttreatment admission are not well understood.</p><p><strong>Methods: </strong>We performed a review of prospectively collected data on patients who received at least 30 HBO₂ sessions for RC associated with gross hematuria at our center. The primary outcome was time to short-term point-of-care urine hematuria resolution. The secondary outcomes included rates of readmission for hematuria management pre HBO₂ and post HBO₂ completion and patient factors associated with these outcomes. Chi-square analyses evaluated associations between clinical characteristics and short-term and long-term outcomes.</p><p><strong>Results: </strong>A total of 43 patients met inclusion criteria, 60% (26/43), 79% (34/42), and 100% (12/12) of patients presenting for HBO₂ with macroscopic hematuria demonstrated resolution of gross hematuria by 20, 40, and 60 treatments, respectively. Hematuria admissions decreased from the year before to after HBO₂ (1.2 admissions pre vs 0.3 post, 95% CI 0.4-1.2, <i>P</i> < .001). Twelve patients (27%) were readmitted after HBO₂ (mean follow-up 2.7 years). A greater proportion of those readmitted had Radiation Therapy Oncology Group scores ≥ 3 (42%, [5/12] vs 7% [1/14], <i>P</i> < .05) and more severe baseline patient-reported hematuria (36% [9/25] vs 7% [1/15], <i>P</i> < .05).</p><p><strong>Conclusions: </strong>HBO₂ was associated with short-term hematuria resolution and fewer long-term hospitalizations for RC hematuria. More severe baseline RC indicators predicted post-HBO₂ hematuria hospitalizations. These findings suggest that some patients may benefit from tailored treatment courses and that early HBO₂ initiation may lead to better long-term outcomes.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"686-694"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265782","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}

{"title":"The Impact of Patient-Provider Relationships on Prostate Cancer Screening: A Cross-Sectional Analysis of the All of Us Research Program.","authors":"Johnny Wang, Hannah Cho, Eric Kim, Mohammad Shahait, David Lee","doi":"10.1097/UPJ.0000000000001054","DOIUrl":"10.1097/UPJ.0000000000001054","url":null,"abstract":"<p><strong>Introduction: </strong>PSA screening is influenced by social, structural, and interpersonal factors. We evaluated whether patient-reported domains of the patient-provider relationship were associated with PSA screening uptake.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of men aged 40 years or older in the All of Us Research Program Controlled Tier data set version 8. The primary outcome was receipt of at least 1 eligible PSA test within a 4-year window spanning 2 years before through 2 years after survey completion. Exposures included respect, collaboration, ease of understanding, and relatability. Multivariable logistic regression was used to assess associations with PSA screening.</p><p><strong>Results: </strong>Among 34,057 men, 10,848 (31.9%) underwent PSA screening. Screening rates decreased across lower response levels for respect, collaboration, and ease of understanding. After adjustment, lower perceived respect was associated with reduced odds of screening for \"most of the time\" (adjusted odds ratio [aOR] 0.89, 95% CI 0.83-0.95) and \"some of the time\" (aOR 0.71, 95% CI 0.59-0.86) vs \"always.\" Lower collaboration was also associated with reduced screening odds across all nonreference levels (aOR range 0.83-0.94), while ease of understanding was significant only for some of the time (aOR 0.80, 95% CI 0.71-0.91). Relatability was not independently associated with screening. These findings were consistent across guideline-oriented age cohorts.</p><p><strong>Conclusions: </strong>Less favorable perceptions of respect, collaboration, and ease of understanding within health care interactions were associated with lower PSA screening uptake. These findings suggest that patient-provider relationship domains represent modifiable factors associated with access to informed, preference-concordant, and risk-appropriate PSA screening.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"612-622"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377572","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}