Urology Practice最新文献_第9页

Cost-Effectiveness Analysis of Using Beta-3 Agonists Over Anticholinergics for Treatment of Overactive Bladder in Reducing Risk and Cost of Anticholinergic-Associated Cognitive Decline. 与抗胆碱能药物相比，使用β -3激动剂治疗膀胱过动症在降低抗胆碱能相关认知能力下降风险和成本方面的成本-效果分析

IF 1.6

Urology Practice Pub Date : 2026-08-28 DOI: 10.1097/UPJ.0000000000001079

Anjali Kapur, Moiuri Siddique, Rui Wang

{"title":"Cost-Effectiveness Analysis of Using Beta-3 Agonists Over Anticholinergics for Treatment of Overactive Bladder in Reducing Risk and Cost of Anticholinergic-Associated Cognitive Decline.","authors":"Anjali Kapur, Moiuri Siddique, Rui Wang","doi":"10.1097/UPJ.0000000000001079","DOIUrl":"10.1097/UPJ.0000000000001079","url":null,"abstract":"Introduction: Anticholinergic (Ach) medications, a mainstay in the treatment of overactive bladder (OAB), are increasingly linked to incident dementia. Beta-3 agonists (B3As) have emerged as an alternative with a more favorable side-effect profile, especially in elderly patients. This study evaluated whether treating OAB with B3A instead of Ach is cost-effective, accounting for the long-term clinical and economic impact of Ach-associated dementia.Methods: A cost-effectiveness analysis was conducted from the health care sector perspective using a Markov microsimulation model comparing Ach and B3A over a 15-year horizon. Model inputs included costs, utilities, and probabilities of health states and adverse events associated with untreated OAB, pharmacotherapy, and minimally invasive therapies. Health states transitioned between untreated OAB, Ach or B3A, minimally invasive therapy, and dementia. Analysis was performed with TreeAge.Results: Over 15 years, total health care costs were $97,001.16 for Ach vs $90,961.30 for B3A, and total quality-adjusted life years were 8.65 vs 8.79, respectively. Sensitivity analysis revealed that B3A alone, compared with Ach alone or Ach followed by B3A, is the dominant strategy, and this held when inputs were varied across their ranges.Conclusions: B3As are cost-saving and more effective than Achs for OAB, largely driven by the elevated dementia risk associated with Ach exposure and the substantial costs and diminished quality of life inherent to dementia. Although clinical guidelines favor eliminating step therapy, many payers still mandate an Ach trial before approving B3A. The long-term burden of Ach-associated dementia exceeds the lower up-front cost of Ach, making B3A more cost-effective overall.","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"101097UPJ0000000000001079"},"PeriodicalIF":1.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851410","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 Cash-Pay Landscape in Urology: A Focus on Men's Sexual Health in the Direct-to-Consumer Era. 现金支付泌尿外科领域：直接面向消费者时代对男性性健康的关注。

IF 1.6

Urology Practice Pub Date : 2026-08-26 DOI: 10.1097/UPJ.0000000000001074

Jaxson Jeffery, Drew Barron, Alex Theophilopoulos, Nahid Punjani

引用次数: 0

Ambient Artificial Intelligence Scribes in Urology: Early Lessons From a Single-System Implementation. 泌尿外科的环境人工智能抄写员：从单一系统实现的早期经验教训。

IF 1.6

Urology Practice Pub Date : 2026-08-26 DOI: 10.1097/UPJ.0000000000001070

Eric J Robinson, Irene K Chen, Aileen S Baecker, Amanda L H DeHaven, Eugene A Chu, Eugene Rhee, Christopher F Tenggardjaja, Karen J Coleman

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How Are Contemporary Urologists Preparing for Board Certification? Lessons From a Decade of American Board of Urology Candidate Survey Data. 当代泌尿科医生如何准备委员会认证？十年来阿布候选人调查数据的经验教训。

IF 1.6

Urology Practice Pub Date : 2026-08-26 DOI: 10.1097/UPJ.0000000000001080

Sasha Mainer, Christopher S Cooper, Sam S Chang, Jay D Raman

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Advancing Male Reproductive Health: Geographic and Structural Gaps in Infertility Care. 推进男性生殖健康：不育护理的地理和结构差距。

IF 1.6

Urology Practice Pub Date : 2026-08-17 DOI: 10.1097/UPJ.0000000000001073

Elie Kaplan-Marans, Oliver Menken, Nicholas A Deebel, Nelson Bennett, Robert E Brannigan

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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

引用次数: 0

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

引用次数: 0

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}

引用次数: 0

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

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