{"title":"Bilateral tailoring, dorsal folding: A simple approach for short urethra and incompetent bladder neck in female patients","authors":"Farzaneh Sharifiaghdas , Amir Soltani-Tehrani , Nazanin Kianinejad , Niloofar Rostaminejad","doi":"10.1016/j.ajur.2024.11.003","DOIUrl":"10.1016/j.ajur.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>Congenital short patulous urethra in females is rare and can lead to varying degrees of urinary incontinence. Surgical options, including bulking agents, urethral and bladder neck reconstruction, fascial slings, and artificial urinary sphincters, have yielded variable results. Based on Hagen–Poiseuille law, we hypothesized that narrowing and folding the urethral lumen could increase intraluminal resistance without resecting any tissue. This study aimed to apply this surgical technique to a small group of female patients and evaluate its short-term outcomes.</div></div><div><h3>Methods</h3><div>We conducted a prospective case series involving incontinent female patients with incompetent bladder necks and widely open urethras. Exclusion criteria included neurogenic bladder dysfunction. Preoperative assessments included physical examination, urinary tract ultrasound imaging, urine analysis, urine culture, conventional standard urodynamic studies, voiding cystourethrography, and cystourethroscopy. For the surgical repair, a suprameatal 3 to 9 o'clock incision was made, and the urethral tissue was dissected to the bladder neck. A 12 Fr Silastic catheter was inserted, and two parallel rows of vertical sutures were placed from the meatus to the bladder neck, creating a central urethral lumen flanked by two smaller lumens. At 3 months and 6 months, patients were assessed for urinary continence.</div></div><div><h3>Results</h3><div>From March 2019 to April 2022, 13 patients (aged 16–50 years) participated, including six with mild epispadias, three with classic exstrophy epispadias syndrome, two with <em>de novo</em> stress urinary incontinence post anterior-posterior repair, one with a failed pubovaginal sling, and one with urethral and bladder damage due to prolonged use of an indwelling urinary catheter. During the 24-month follow-up period, 11 of 13 (85%) patients achieved continence. The two failures were in classic exstrophy patients, who subsequently underwent augmentation ileocystoplasty and bladder neck repair.</div></div><div><h3>Conclusion</h3><div>This study presents a novel, less invasive surgical approach for treating a patulous urethra and bladder neck incompetence in females. It may serve as an alternative to more complex surgical techniques for selected cases.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 94-100"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asian Journal of UrologyPub Date : 2026-01-01Epub Date: 2025-07-23DOI: 10.1016/j.ajur.2025.06.003
Mattia Longoni , Paolo Zaurito , Pietro Scilipoti , Leonardo Quarta , Francesco Barletta , Simone Scuderi , Armando Stabile , Luigi Nocera , Pawel Rajwa , Fabio Zattoni , Giancarlo Marra , Pierre I. Karakiewicz , Francesco Montorsi , Alberto Briganti , Giorgio Gandaglia
{"title":"Decision regret after robot-assisted radical prostatectomy: A systematic review and meta-analysis","authors":"Mattia Longoni , Paolo Zaurito , Pietro Scilipoti , Leonardo Quarta , Francesco Barletta , Simone Scuderi , Armando Stabile , Luigi Nocera , Pawel Rajwa , Fabio Zattoni , Giancarlo Marra , Pierre I. Karakiewicz , Francesco Montorsi , Alberto Briganti , Giorgio Gandaglia","doi":"10.1016/j.ajur.2025.06.003","DOIUrl":"10.1016/j.ajur.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Robot-assisted radical prostatectomy (RARP) is the most commonly performed surgical treatment for prostate cancer. However, decision regret (DR) represents a concern for both patients undergoing the procedure and clinicians involved in therapeutic management. To address this need, we performed a systematic review exploring DR severity and its associations after RARP.</div></div><div><h3>Methods</h3><div>A comprehensive search in scientific literature databases (PubMed, Embase, Scopus, and Web of Science) identified studies on DR in RARP-treated patients. All studies objectively evaluating DR were included. Within studies using the validated 5-item DR scale (range 0–100), the pooled estimate was calculated using fixed- and random-effects models accounting for different follow-ups. A qualitative synthesis analyzed the impact of multiple baseline, perioperative, and postoperative factors on DR.</div></div><div><h3>Results</h3><div>We retrieved 493 articles using our search strategy, with 15 meeting inclusion criteria. A total of 3480 prostate cancer patients with objective DR assessment after RARP were identified. The median follow-up ranged from 4.8 months to 6.3 years while response rates varied between 45% and 100%. Among the included studies, 10 used the Decision Regret Scale, with a pooled mean estimate of 15.22 (95% confidence interval 11.52–18.93) under the random-effects model. In the remaining five studies, DR was generally low (65%–75%) and even absent in some (12%–49%). Functional outcomes, such as continence and potency, were the most frequently reported factors significantly associated with DR. However, variability in assessing DR and other outcomes limits the ability to draw definitive conclusions.</div></div><div><h3>Conclusion</h3><div>Most patients report low DR after RARP. Functional outcomes correlate with DR, but the heterogeneity in assessments and reporting methods warrants the need for more standardized evaluation.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 1-10"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asian Journal of UrologyPub Date : 2026-01-01Epub Date: 2025-05-21DOI: 10.1016/j.ajur.2025.01.003
Guolong Liao, Xianju Chen, Jun Pang
{"title":"The modified Devine procedure for penile reconstruction: A retrospective study of 80 cases","authors":"Guolong Liao, Xianju Chen, Jun Pang","doi":"10.1016/j.ajur.2025.01.003","DOIUrl":"10.1016/j.ajur.2025.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>Concealed penis is a common congenital genital abnormality. This study aimed to introduce a penile reconstruction method for concealed penis, namely the modified Devine procedure, and evaluate its safety and efficacy.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 80 consecutive patients with concealed penis, who underwent surgical correction between May 2019 and May 2023 in our department. All patients underwent a modified Devine procedure. Data on the patients’ age, body mass index, operative time, blood loss, preoperative and postoperative penile lengths, and postoperative complications were collected and analyzed.</div></div><div><h3>Results</h3><div>All operations were successful. Patients had a mean age of 10.30 (standard deviation [SD] 1.07) years and a mean body mass index of 20.26 (SD 2.26) kg/m<sup>2</sup>. The mean operative time was 56.35 (SD 8.62) min, and the mean volume of blood loss was 6.58 (SD 1.34) mL. The mean follow-up time was 15.97 (SD 2.92, range 12–24) months. Penile length increased significantly at 1 month and 12 months postoperatively, with continued growth over time. No major complications occurred. Mild lymphedema was the most common minor complication but resolved spontaneously within 6 weeks. No other adverse events were observed.</div></div><div><h3>Conclusion</h3><div>The modified Devine procedure for concealed penis achieved clinically safe and effective penile reconstruction outcomes, as well as satisfactory cosmetic appearance. Given its favorable results and minimal complications, this surgical approach appears to be a promising surgical option for selected patients with concealed penis.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 116-120"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asian Journal of UrologyPub Date : 2026-01-01Epub Date: 2025-04-10DOI: 10.1016/j.ajur.2025.03.005
Danai Manorom
{"title":"Trends and projections in prostate cancer epidemiology in Thailand: A population-based cancer registry analysis","authors":"Danai Manorom","doi":"10.1016/j.ajur.2025.03.005","DOIUrl":"10.1016/j.ajur.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate trends in the incidence and mortality of prostate cancer (PCa) in Thailand from 1990 to 2017 and project future rates up to 2040. It also aimed to examine incidence and mortality trends across 12 health districts and Bangkok from 2012 to 2020.</div></div><div><h3>Methods</h3><div>Data on PCa cases diagnosed between 1990 and 2017 were obtained from Thailand's Population-based Cancer Registry. Age-specific incidence rates were adjusted to the Segi World Standard Population as recommended by the WHO. The joinpoint regression analysis identified significant changes in trends and estimated the annual percent change. Projections were made using the joinpoint regression model. District-specific incidence rates and mortality rates from 2012 to 2020 were calculated for 12 health districts and Bangkok.</div></div><div><h3>Results</h3><div>From 1990 to 2017, 18 192 new PCa cases were diagnosed in Thailand, with 95% in men aged 50 years and older. The age-standardised incidence rate more than doubled from 3.84 to 7.72 cases per 100 000 person-years, with a significant estimated annual percent change of 2.7% (95% CI 1.7%–4.1%; <em>p</em><0.05). Projections indicated the age-standardised incidence rate for men aged 50 years and older would rise from 8.3 cases per 100 000 person-years in 2018 to 15.4 by 2040. The 12 health districts and Bangkok showed variable incidence rates, with significant increases in several districts and fluctuating mortality rates (<em>p</em><0.05).</div></div><div><h3>Conclusion</h3><div>PCa incidence rates and mortality rates in Thailand have significantly increased over the past decades. With an aging population, these trends are expected to continue, posing a growing public health challenge. These findings highlight the urgent need for effective cancer control strategies and updated epidemiological data to support policy-making.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 37-44"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of three-dimensional reconstruction on ischaemic time and operative time in robot-assisted partial nephrectomy","authors":"Deerush Kannan Sakthivel , Sindhu Sankaran , Madhav Tiwari , Sandeep Bafna , Narasimhan Ragavan","doi":"10.1016/j.ajur.2025.01.006","DOIUrl":"10.1016/j.ajur.2025.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>Partial nephrectomy (PN) is the standard treatment for T1a renal masses, increasingly applied to T1b tumours due to advancements in robotic surgery and imaging. While CT urograms are standard, three-dimensional (3D) reconstruction is gaining traction for complex tumours to enhance preoperative planning. This study aimed to compare the impact of 3D reconstruction on operative time and ischaemic time during robot-assisted PN.</div></div><div><h3>Methods</h3><div>A prospective, non-randomised study was conducted on 112 patients who underwent robot-assisted PN between January 2020 and October 2022. Patients were divided into two groups: Group A (<em>n</em>=56) with the aid of 3D reconstruction for complex tumours and Group B (<em>n</em>=56) without 3D reconstruction. Operative time and ischaemic time were analysed, along with other outcomes such as margin positivity and postoperative complications.</div></div><div><h3>Results</h3><div>Despite higher tumour complexity in Group A, mean operative time (190.1 [standard deviation, SD 38.5] min <em>vs.</em> 189.3 [SD 42.6] min) and mean ischaemic time (20.4 [SD 5.6] min <em>vs.</em> 20.3 [SD 5.3] min) were comparable between Group A and Group B. Margin positivity and complications were also similar, suggesting that 3D reconstruction aids in efficient surgery even for complex cases.</div></div><div><h3>Conclusion</h3><div>3D reconstruction enhances understanding of complex renal tumours, maintaining operative efficiency comparable to less complex cases. Further randomized studies are needed to confirm these findings.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 52-55"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploration of the association of antidiabetic drugs with urolithiasis: A drug-targeted Mendelian randomization study","authors":"Xidong Wang, Qiancheng Mao, Tianqi Wang, Yingying Yang, Ming Liu, Jitao Wu","doi":"10.1016/j.ajur.2025.03.012","DOIUrl":"10.1016/j.ajur.2025.03.012","url":null,"abstract":"<div><h3>Objective</h3><div>Type 2 diabetes mellitus has previously been reported to be potentially associated with urolithiasis. We conducted a Mendelian randomization (MR) study to explore whether there is a causal relationship between genetic susceptibility to common antidiabetic drugs and urolithiasis risk.</div></div><div><h3>Methods</h3><div>We used genetic variants from two different sources as instruments to proxy the exposure to antidiabetic drugs for our MR research design. The variants included loci regulating expression traits of the target genes, and genetic variants associated with blood glucose nearby or within antidiabetic drug target genes from genome-wide association studies. We ultimately calculated estimates using inverse-variance weighted MR (IVW-MR) and summary-data-based MR methods.</div></div><div><h3>Results</h3><div>The Bonferroni-corrected IVW results suggested potassium inwardly rectifying channel subfamily J member 11 (<em>KCNJ11</em>)-mediated blood glucose was associated with a lower risk of urolithiasis (odds ratio [OR]: 0.15; 95% confidence interval [CI]: 0.06–0.39; <em>p</em>=1.19×10<sup>−4</sup>). Similarly, we also observed a higher expression of <em>KCNJ11</em> was linked to a decreased risk of urolithiasis in the summary-data-based MR analysis (OR: 0.81 per 1 mmol/L decrement in blood glucose; 95% CI: 0.70–0.95; <em>p</em>=0.008). We found suggestive evidence of the positive relationship between insulin receptor expression and urolithiasis (OR: 5.67; 95% CI: 1.01–31.97; <em>p</em>=0.049), which was not supported when using <em>cis</em>-expression quantitative trait locus as an instrument.</div></div><div><h3>Conclusion</h3><div>This study provided evidence for a potential causal link between <em>KCNJ11</em>-mimicked sulfonylureas and the reduced risk of urolithiasis. Given the limitations of this study, it is essential to investigate further using the latest data from large-scale genetic studies and relevant clinical data to validate our findings from the MR study.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 56-66"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asian Journal of UrologyPub Date : 2026-01-01Epub Date: 2025-10-20DOI: 10.1016/j.ajur.2025.02.001
Su Lin , Pan Hu , Hui Nie , Li Lei , Yingxia He , Lin Feng , Limei Zhao , Chunhua Han , Lubin Liu
{"title":"Analysis of differences in Pelvic Organ Prolapse Quantification scores at different anatomical sites before and after anesthesia for guiding surgical planning in female patients with pelvic organ prolapse","authors":"Su Lin , Pan Hu , Hui Nie , Li Lei , Yingxia He , Lin Feng , Limei Zhao , Chunhua Han , Lubin Liu","doi":"10.1016/j.ajur.2025.02.001","DOIUrl":"10.1016/j.ajur.2025.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the differences in Pelvic Organ Prolapse Quantitation (POP-Q) scores before and after anesthesia in patients with pelvic organ prolapse at different sites and explore the influence of POP-Q scores on surgical decision making.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted involving 60 female patients with pelvic organ prolapse who underwent surgical treatment at the Chongqing Health Center for Women and Children between January 2023 and June 2023. The cohort included 26 patients with uterine prolapse and 34 patients with cystocele. POP-Q scores and other relevant data were compared under two conditions: before anesthesia (with Valsalva maneuver) and after anesthesia (with cervical traction).</div></div><div><h3>Results</h3><div>There were no statistical differences in the mean age, menopausal status, mean body mass index, mean number of pregnancies, or related primary diseases between the two groups <em>(p></em>0.05). The minimum tractive force required for cervical traction after anesthesia was 4.81 N. In both groups, the POP-Q scores for points C, D, and Bp were significantly higher after anesthesia than before anesthesia (<em>p</em><0.05). In the uterine prolapse group, there were no significant changes in the scores for points Aa, Ba, and Ap before and after anesthesia (<em>p</em>>0.05). However, in the cystocele group, the score for point Aa decreased significantly after anesthesia compared to before anesthesia (<em>p</em>=0.016).</div></div><div><h3>Conclusion</h3><div>The increased scores of points C, D, and Bp after anesthesia suggest that the evaluations of uterine prolapse should be based on post-anesthesia measurements. Conversely, evaluations of cystocele should rely on pre-anesthesia measurements due to the decrease in point Aa scores observed after anesthesia.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 101-106"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asian Journal of UrologyPub Date : 2026-01-01Epub Date: 2025-02-14DOI: 10.1016/j.ajur.2024.12.002
Cheng Lian , Zixian Wang , Xu Gao , Gong-Hong Wei
{"title":"Systematic investigation of zinc finger MYND-type containing 11-mediated alternative splicing reveals notable events in prostate cancer","authors":"Cheng Lian , Zixian Wang , Xu Gao , Gong-Hong Wei","doi":"10.1016/j.ajur.2024.12.002","DOIUrl":"10.1016/j.ajur.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>Alternative splicing (AS) is increasingly recognized as a hallmark of cancer, contributing to tumor progression and therapeutic resistance. Zinc finger MYND-type containing 11 (ZMYND11), a critical reader of the histone modification H3.3K36me3, is frequently downregulated in various cancers. However, its specific role in regulating AS in prostate cancer (PCa) remains unclear. This study aimed to elucidate the mechanisms by which ZMYND11 modulates AS in PCa and evaluate its potential as a therapeutic target.</div></div><div><h3>Methods</h3><div>The comprehensive AS analysis was conducted using two bioinformatics tools, SUPPA2 and rMATS, applied to data from <em>ZMYND11</em> knockdown PCa cell lines and a large cohort of PCa patient samples. Candidate ZMYND11-mediated AS events were identified based on overlapping results from both tools. Experimental validation was performed in multiple PCa cell lines, and confirmed findings were classified as notable AS events.</div></div><div><h3>Results</h3><div>SUPPA2, with a threshold of an absolute <em>Δ</em>PSI >0.1 and <em>p</em>-value <0.05, was identified as the optimal tool for detecting ZMYND11-mediated AS events. A total of 19 candidate AS events were identified, with approximately 50% involving exon skipping. Experimental validation highlighted three notable AS events affecting mitogen-activated protein kinase kinase kinase kinase 4 (MAP4K4), golgin B1 (GOLGB1), and Dmx like 1 (DMXL1). These events are implicated in key pathways influencing tumor growth and metastasis, underscoring the tumor-suppressive role of ZMYND11 in PCa.</div></div><div><h3>Conclusion</h3><div>This study systematically characterizes ZMYND11-mediated AS in PCa, revealing its pivotal role in modulating splicing events critical to tumor progression. The findings establish ZMYND11 as a potential biomarker and a promising source of novel therapeutic targets for PCa management.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 1","pages":"Pages 24-36"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}