Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Should magnetic resonance imaging be considered in every patient before a bladder outflow obstruction procedure?","authors":"Ivo Donkov, Nikolaos Chatzikrachtis, Abhisekh Chatterjee, Tevita Aho, Mark Emberton, Panagiotis Nikolinakos","doi":"10.4081/aiua.2025.13935","DOIUrl":"10.4081/aiua.2025.13935","url":null,"abstract":"<p><p>To the Editor, Benign prostatic hyperplasia (BPH) is a highly prevalent histological condition in aging men that can commonly cause lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). BPH typically begins developing after the age of 40 and affects approximately 50-60% of men by age 60...</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13935"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152295","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":"ChatGPT artificial intelligence in clinical data analysis: an example comparing standard <i>vs</i> fusion prostate biopsy outcomes after robotic-assisted radical prostatectomy (RaRP).","authors":"Pier Paolo Prontera, Francesca Romana Prusciano, Marco Lattarulo, Arman Tsaturyan, Francesco Addabbo, Carmine Sciorio, Francesco Saverio Grossi","doi":"10.4081/aiua.2025.13596","DOIUrl":"10.4081/aiua.2025.13596","url":null,"abstract":"<p><strong>Objective: </strong>To compare statistical outputs from ChatGPT 4.0 and human experts in both comparative and correlation analyses in the evaluation of multiparametric MRI/ultrasound fusion-targeted biopsy plus random biopsy versus standard random biopsy alone, in terms of upstaging.</p><p><strong>Methods: </strong>Authors performed a retrospective evaluation on 101 patients undergoing robot-assisted radical prostatectomy (RaRP) between 2021 and 2023. Patients were divided in two groups, according to the type of prostatic biopsy received: combined fusion (MRI/US) targeted and random biopsy versus standard random biopsy. Clinical and histological data were anonymized and analyzed using logistic regression models, ANOVA, and Chi-square tests. Analysis generated by ChatGPT and by an experienced human statistician were compared. The Q-EVAL and Q-EVA tools were used to assess the quality of user-formulated questions and AI-generated answers, respectively.</p><p><strong>Results: </strong>Results revealed high concordance between statistical outputs generated by AI and expert human statistician with perfect concordance using Cohen's kappa coefficient (κ = 1.0). Logistic regression analysis demonstrated that fusion biopsy was associated with a reduced likelihood of upstaging, a consistent finding across statistical evaluations. Additionally, user interaction assessments indicated high-quality in question formulation.</p><p><strong>Conclusions: </strong>ChatGPT (version 4.0) proved reliable for statistical analysis, showing strong concordance with human statisticians (κ = 1.0) in performing logistic regression, chi-square, and ANOVA tests. The Q-EVAL tool could reduce query errors, though ChatGPT's lack of automatic citations remains a limitation. Fusion biopsy significantly lowered upstaging risk after RaRP. In conclusion, ChatGPT is a valuable assistive tool but further research is required to optimize human-AI collaboration in clinical research.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13596"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081350","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":"Evaluating hormonal differences in post-orchidopexy patients: a meta-analysis of palpable <i>vs.</i> nonpalpable undescended testis.","authors":"Marshal Harvy Wicaksono Pantjoro, Anak Agung Ngurah Krisnanta Adnyana, Gede Wirya Kusuma Duarsa","doi":"10.4081/aiua.2025.13903","DOIUrl":"10.4081/aiua.2025.13903","url":null,"abstract":"<p><strong>Introduction: </strong>Cryptorchidism or undescended testis (UDT) is one of the most common congenital anomalies in male infants. Based on the physical examination, UDT can be classified into palpable and non-palpable. However, despite successful repositioning, the long-term function of the testis is still a concern. This meta-analysis aims to compare the testicular function of palpable UDT and non-palpable UDT post-orchidopexy using hormonal markers such as FSH, LH, and testosterone.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was performed using PubMed, ScienceDirect, and Google Scholar databases up to March 2025. Statistical analyses were conducted using Review Manager (RevMan).</p><p><strong>Results: </strong>Four eligible studies were included in the analysis, involving 207 patients who underwent orchidopexy for UDT, including 160 with palpable UDT and 47 with non-palpable UDT. There is no significant difference between palpable compared to non-palpable in terms of FSH (MD 0.78 IU/L [95% CI: -0.34 to 1.90], p = 0.14); LH (MD -0.17 IU/L [95% CI: -0.45 to 0.12], p = 0.25); and testosterone (-0.08 IU/L [95% CI: -0.64 to 0.48], p = 0.78).</p><p><strong>Conclusions: </strong>Testicular functions, including FSH, LH, and testosterone, in palpable UDT did not differ significantly from those in non-palpable UDT.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 2","pages":"13903"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530337","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":"Management of urinary stones by experts in stone disease (ESD 2025).","authors":"Athanasios Papatsoris, Bogdan Geavlete, George Daniel Radavoi, Mohammed Alameedee, Murtadha Almusafer, M Hammad Ather, Alberto Budia, Alin Adrian Cumpanas, Murat Can Kiremi, Athanasios Dellis, Mohamed Elhowairis, Juan Antonio Galán-Llopis, Petrisor Geavlete, Jordi Guimerà Garcia, Bernat Isern, Viorel Jinga, Juan Manuel Lopez, Juan Antonio Mainez, Iraklis Mitsogiannis, Jorge Mora Christian, Mohammad Moussa, Razvan Multescu, Yusuf Oguz Acar, Kremera Petkova, Adrià Piñero, Elenko Popov, Maria Ramos Cebrian, Stefan Rascu, Roswitha Siener, Petros Sountoulides, Kyriaki Stamatelou, Jaffry Syed, Alberto Trinchieri","doi":"10.4081/aiua.2025.14085","DOIUrl":"10.4081/aiua.2025.14085","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The formation of kidney stones is a complex biologic process involving interactions among genetic, anatomic, dietary, and environmental factors. Traditional lithogenic models were based on urine supersaturation in relation to the activity of crystallization promoters and inhibitors. However, modern research has added new principles such as the \"renal epithelial cell response\" and the role of inflammation and oxidative stress leading to the development of a \"multi-hit hypothesis\". A strong correlation between urinary stones and kidney damage has been well demonstrated by both cohort and case-control studies. The main contributors to chronic kidney damage associated with urinary stones include crystal deposition within the renal parenchyma, associated comorbidities, repeated obstructive and infectious episodes, as well as the potential adverse effects of stone removal procedures. Most hereditary stones may cause high urinary saturation levels promoting obstruction of the Bellini ducts and consequent glomerulosclerosis and interstitial fibrosis in the cortex. These include hereditary hypercalciurias, primary hyperoxalurias, cystinuria, adenine phosphoribosyltransferase (APRT) deficiency (associated with 2,8-dihydroxyadenine lithiasis) and xanthinuria. Complete distal renal tubular acidosis occurs in childhood and presents deafness, rickets, and a short life expectancy. The incomplete form usually manifests in adulthood, primarily with recurrent urinary lithiasis, and less frequently with nephrocalcinosis. In all stone formers stone analysis and a basic metabolic evaluation, including blood biochemistry, urine sediment examination, urinary pH and culture are mandatory, in contrast high-risk stone formers require a more specific metabolic evaluation, including a 24-hour urine sample to measure calcium, phosphate, citrate, oxalate, uric acid, magnesium, sodium and proteinuria. The morpho compositional analysis of kidney stones offers essential insights beyond merely identifying their predominant chemical component. This approach reveals key aspets of the stone formation, such as nucleation sites, crystal growth patterns, and the presence of specific lithogenic processes. The ideal analytical protocol combines stereoscopic microscopy (StM), scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS), and, when necessary, Fourier-transform infrared spectroscopy (FTIR). Recurrence prevention and managing residual fragments require complementary strategies such as lifestyle modifications, dietary interventions, and pharmacological therapies. Among pharmacological options, alkaline citrate salts, particularly potassium citrate, are widely used due to their ability to modify urinary chemistry and inhibit stone formation. Recently, novel molecules have been introduced into the management of renal stone disease. Phytate a naturally occurring polyphosphorylated carbohydrate, exibits a potent inhibitory effect on calcium salt's nucleat","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 2","pages":"14085"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530339","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 effect of flavonoid and subclasses supplementation on prostate specific antigen, hormonal parameters and prostate cancer risk: a systematic review and meta-analysis of randomized controlled trials.","authors":"Abdul Azis, Andi Asadul Islam, Haerani Rasyid, Lukman Hakim, Syakib Bakri, Agussalim Bukhari, Andi Alfian Zainuddin","doi":"10.4081/aiua.2025.13645","DOIUrl":"10.4081/aiua.2025.13645","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Prostate cancer (PCa) is a significant concern and burden worldwide. Several studies suggest that flavonoids have a significant potential as an anti-cancer agent, but the evidence remains controversial. This study aims to assess the effect of flavonoids and its subclasses supplementation on PCa risk parameters in men with biopsy-proven diagnosis of PCa or clinically determined to have a high risk of PCa.</p><p><strong>Materials and methods: </strong>This systematic review and meta-analysis adhered to PRISMA guideline. A literature search was conducted across PubMed, ScienceDirect, Scopus and Cochrane utilizing PICO framework. Revised Cochrane's risk of bias tools (RoB2) was used for quality analysis. Review manager 5.4 was used for statistical analysis.</p><p><strong>Results: </strong>Out of 1.117 articles, nine final studies (involving 420 patients) were included. Regarding total PSA, flavonoid provided a reduction of total PSA (MD: -0.64, p<0.05), and sub-group analysis based on the supplementation duration showed flavonoid administration with a duration of ≥12 weeks significantly reduced total PSA compared to administration of <12 weeks (p<0.05). Meta-analyses of four studies, including men clinically at risk of PCa, revealed that flavonoid supplementation was associated with a significantly lower risk of developing PCa at endpoint (OR 0.41, p<0.05). However, our results indicated no favorable effect on hormonal parameters.</p><p><strong>Conclusions: </strong>The results of this meta-analysis suggest there may be a potential role for flavonoid in PCa risk reduction. Flavonoids supplementation also have been proven to be safe. However, further investigation is necessary to gain a clear understanding of the flavonoid impact on PSA and sex hormone parameters.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13645"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052912","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":"Current status of management and outcomes of muscle-invasive bladder cancer in Yemen: a retrospective observational study.","authors":"Khaled Al-Kohlany, Amal Al-Maleki, Majdi Al-Shami, Hani Hussein, Faisal Ahmed","doi":"10.4081/aiua.2025.13760","DOIUrl":"10.4081/aiua.2025.13760","url":null,"abstract":"<p><strong>Background: </strong>The lack of a cohesive diagnostic and therapeutic framework for muscle-invasive bladder cancer (MIBC) in Yemen has resulted in significant variability in patient care. This study evaluates oncological outcomes and survival rates after radical cystectomy (RC) for MIBC patients in Yemen.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 300 MIBC patients who underwent RC between 2006 and 2020. Demographics, histopathological findings, and survival data were meticulously collected. Kaplan-Meier survival analysis estimated survival probabilities, while prognostic factors were evaluated using the log-rank test.</p><p><strong>Results: </strong>The median patient age was 67 years (IQR 65-70), with a male predominance (n=184, 61.3%). Ileal loop reconstruction was the primary method of urinary diversion (n=234, 78.0%). Urothelial carcinoma was the predominant diagnosis (n=246, 82.0%), followed by squamous cell carcinoma (n=42, 14.0%). Postoperative complications occurred in 93 patients (31.0%), primarily Grade I (n=61, 20.3%). Overall survival was 71.7% (n 215), with 28.3% mortality due to non-cancer-related (n=43, 14.3%) and bladder cancer-related causes (n=35, 11.7%). The median overall survival was 191 months, with 1-year, 3-year, 5-year, and 10-year survival rates of 99%, 93%, 88%, and 82%, respectively. In the multivariate analysis, non-ileal conduit diversion (Hazard Ratio [HR] 5.21, 95% Confidence Interval [CI]: 1.80-15.00, p=0.003), Stage IV disease (HR 2.76, 95% CI: 1.01-7.61, p=0.050), lymph node positivity (HR 2.92, 95% CI: 1.15-7.42, p=0.022), and squamous cell carcinoma (HR 3.09, 95% CI: 1.25-7.63, p=0.022) were identified as predictors of mortality.</p><p><strong>Conclusions: </strong>This study highlights the urgent need for improved bladder cancer care in Yemen. Late-stage diagnosis and suboptimal surgical methods critically affect survival. Addressing these issues requires prioritizing early detection and standardized surgical techniques to develop effective care pathways for MIBC patients.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13760"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003895","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":"Inguinal hernia repair: a comparison of strengthening the posterior inguinal wall with aponeuroplasty <i>versus</i> the Lichtenstein technique (mesh repair). A randomized controlled trial in a low-resource setting.","authors":"Saif Ghabisha, Faisal Ahmed, Ahmed Ateik","doi":"10.4081/aiua.2025.13790","DOIUrl":"10.4081/aiua.2025.13790","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernia repair is a frequently performed surgical procedure that generally employs prosthetic mesh. However, alternative techniques, notably the reinforcement of the posterior inguinal wall through aponeuroplasty, have not been sufficiently explored, particularly in resource-constrained environments. This study aims to evaluate and compare the efficacy and outcomes of aponeuroplasty against traditional mesh repair in adult patients with inguinal hernias.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted from April 1, 2019, to May 22, 2024, enrolling 200 adult patients diagnosed with inguinal hernias. Participants were randomized into either Group A (Lichtenstein technique with prosthetic mesh repair, n=96) or Group B (posterior inguinal wall aponeuroplasty, n=104). Patients were monitored for a minimum of two year postoperatively. The aponeuroplasty technique required meticulous dissection of the external oblique and transversus abdominis aponeuroses, ensuring tissue integrity and securing the tissue to the inguinal ligament and muscle arch. Complications, recurrence rates, and other surgical outcomes were systematically analyzed.</p><p><strong>Results: </strong>Demographic analyses revealed no significant differences between groups. Group B demonstrated significantly shorter operative times (30 ± 9.43 min vs. 38 ± 12.55 min, p=0.004) and lower postoperative pain levels (p=0.031). Over the follow-up period of two years, hydroceles were documented in 9 patients (4.5%), with a notably lower incidence in Group B (1 case, 1.0%) compared to Group A (8 cases, 8.3%, p=0.030). Recurrence rates were similar in both groups (3 in Group A and 2 in Group B, p=0.613).</p><p><strong>Conclusions: </strong>Strengthening the posterior inguinal wall via aponeuroplasty offers superior outcomes compared to prosthetic mesh repair, particularly regarding postoperative pain and operative time. These findings advocate for the consideration of aponeuroplasty as an effective surgical alternative for inguinal hernia repair in low-resource settings. Future studies are warranted to validate these conclusions across diverse and larger populations.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13790"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040925","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":"Kidney stones and metabolic bone diseases not linked to parathyroid disfunction: a proposal for an integrated management.","authors":"Anita Vergatti, Veronica Abate, Matteo Della Monica, Alfonso Varriale, Simone Magelli, Francesca Garofano, Lanfranco D'Elia, Antonio Barbato, Gianpaolo De Filippo, Domenico Rendina","doi":"10.4081/aiua.2025.13870","DOIUrl":"10.4081/aiua.2025.13870","url":null,"abstract":"<p><p>Nephrolithiasis (KS) and metabolic bone diseases (MBDs) not linked to parathormone (osteoporosis, Paget's disease of bone and renal phosphate leak) are related as demonstrated by epidemiological and experimental data. Moreover, patients affected by monogenic kidney stone disorders (idiopathic hypercalciuria, primary hyperoxaluria, hypocitraturia, cystinuria and defects in purine metabolism) showed a bone phenotype. A significant economic and social burden is associated with KS and MBDs, due to high mortality and morbidity rate. Concerning this point of view, an integrated screening could be a cost-saving strategy. We suggest a new clinical management for patients affected by KS and MBDs. The assessment of bone mineral density by Dual X-ray absorptiometry and bone turnover markers should be proposed in KS patients. On the contrary, the evaluation of KS-related metabolic risk factor and an abdomen ultrasound exam should be offered to MBD patients. Moreover, in patients with early and/or recurrent KS, an extended gene-panel should be suggested.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13870"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318310","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":"Supratrigonal systectomy: last line treatment for radiation-induced hemorrhagic cystitis.","authors":"José Alberto Pereira, Duarte Vieira-Brito, Mário Lourenço, Paulo Conceição, Ricardo Godinho, Pedro Peralta, Bruno Jorge Pereira, Carlos Rabaça","doi":"10.4081/aiua.2025.13492","DOIUrl":"10.4081/aiua.2025.13492","url":null,"abstract":"<p><strong>Introduction: </strong>Hemorrhagic cystitis is defined by the presence of hematuria, lower urinary tract symptoms and cystoscopy findings indicative of underlying urothelial damage. It is common in patients with prior radiotherapy for pelvic malignancies. The severity of the bleeding can vary from mild to severe hematuria refractory to conservative therapy and with a continuous need for transfusions. Treatment can be challenging not only by the lack of clear guidelines but also the multiple comorbidities of these patients. Urinary diversion with or without cystectomy should be reserved for those who have failed all the previously available therapy, because of the morbidity/mortality associated with this type of procedure. Supratrigonal cystectomy can be an option in patients with intense fibrosis of the pelvic region. The purpose of this article is to present the results of our institution with supratrigonal cystectomy with urinary diversion as a last line treatment for radiation-induced hemorrhagic cystitis.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 17 patients who underwent supratrigonal cystectomy and bladder mucosa fulguration with urinary diversion for refractory radiation-induced hemorrhagic cystitis in our institution from January 2010 to December 2020.</p><p><strong>Results and discussion: </strong>Median patient age at time of cystectomy was 69 years and 64.7% (11) were females. The most common etiology was prior radiation therapy for gynecologic malignancies (11-64.7%). All the patients had prior therapy with bladder irrigation and fulguration. Besides that, 29.4% (n=5) received intravesical therapy with formalin, 11.8% (n=2) hyperbaric oxygen therapy and 5.9% (n=1) prior urinary diversion. Median time between radiation therapy and cystectomy was 65 months. Median ASA score of 3, median preoperative hemoglobin was 9,6mg/dl and 10.5 mg/dl at time of discharge after surgery. Ileal conduit was used in 52.9% (9), cutaneous ureterostomy in 41.2% (7) and ureterosigmoidostomy in 5.9% (1). Majority of patients (10-58.8%) did not require any blood transfusion during surgery or during their stay. Clavien-Dindo complications grade III or higher occurred in 29,4% (5). Median hospital stay postoperative was 12 days. No mortality was reported in the 30 days after surgery. Median follow-up after cystectomy was 28 months, with a 1-year survival of 93.3% (14 of 15) and 3-year survival of 83.3% (10 of 13). There was no difference in the presence of postoperative complications or overall survival between the types of urinary diversion.</p><p><strong>Conclusions: </strong>This represents one of the largest series on cystectomy in hemorrhagic cystitis, that we found to this date. Supratrigonal cystectomy is a valid option as a last line treatment for radiation-induced hemorrhagic cystitis, reducing the risks associated with simple cystectomy in patients with prior pelvic radiation.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13492"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152296","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":"Sexual outcome of vasectomized patients: a systematic review.","authors":"Marshal Harvy Wicaksono, Ronald Sugianto, Gede Wirya Kusuma Duarsa","doi":"10.4081/aiua.2025.13644","DOIUrl":"10.4081/aiua.2025.13644","url":null,"abstract":"<p><strong>Introduction: </strong>Vasectomy is one of the most effective ways of contraception. However, it still has various complications, including post-vasectomy sexual dysfunction. Some studies suggest that one of the sexual performance problems can be linked to psychological factors. However, other studies indicate that vasectomy can have positive effects on patient's sexual lives. Because of these conflicting findings, the purpose of this article is to examine the sexual outcome post-vasectomy using a systematic review of current studies.</p><p><strong>Methods: </strong>We performed the search using electronic databases MEDLINE, Pub Med, and Science Direct. We used \"vasectomy\", \"vasectomies\", and \"sexual outcome\", and \"sexual quality\" in the text keywords. Eleven studies, six case-control studies, and five cohorts met the inclusion criteria for this review.</p><p><strong>Results: </strong>Studies reported a significant improvement in IIEF scores, sexual desire, sexual satisfaction, and orgasm domain after vasectomy. However, a study found that low acceptance of vasectomy can lead to erectile dysfunction, and vasectomized men are slightly more likely to report problems in maintaining their erections.</p><p><strong>Conclusions: </strong>This systematic review shows that, although rare, there are complications after vasectomy. These complications can be related to decreased sexual function for patients after vasectomy. As a urologist, it is essential to offer adequate counseling to patients before vasectomy.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13644"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102956","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}