Indian Journal of Urology最新文献

{"title":"Combined gabapentin and solifenacin for symptom management after double-J stent insertion: Randomized controlled trial.","authors":"Salman Soltani, Mahmoud Tavakkoli, Maryam Emadzadeh, Hamidreza Ghorbani, Kamyar Tavakkoli Tabassi, Atena Aghaee, Mohammad Ramezani","doi":"10.4103/iju.iju_166_25","DOIUrl":"10.4103/iju.iju_166_25","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteral stents are widely used in various urological procedures; however, they are frequently associated with bothersome symptoms that affect patient quality of life. This study aimed to evaluate the additive effect of gabapentin combined with solifenacin in controlling stent-associated symptoms following double-J stent placement after ureteroscopic lithotripsy.</p><p><strong>Methods: </strong>This prospective randomized controlled trial was conducted between 2019 and 2021 at a tertiary referral center. Adult patients who underwent ureteroscopic lithotripsy for unilateral ureteral stones with subsequent double-J stent placement were included. A total of 160 patients were randomized into two groups. The intervention group received gabapentin 100 mg plus solifenacin 5 mg daily, whereas the control group received Solifenacin 5 mg daily plus placebo for 2 weeks. Symptom severity was evaluated using the Ureteral Stent Symptom Questionnaire (USSQ) 2 weeks postoperatively.</p><p><strong>Results: </strong>The mean total USSQ score was significantly lower in the intervention group (75.17 ± 13.90) compared to the control group (87.98 ± 17.44; <i>P</i> < 0.001). In addition, the intervention group demonstrated significant improvements in urinary symptoms, pain, general health, work performance, and other domains (<i>P</i> < 0.05 for all).</p><p><strong>Conclusions: </strong>Gabapentin appears to be a safe and effective adjunct for reducing symptoms associated with ureteral stent placement, particularly reducing pain and improving general health status. Its combination with solifenacin may offer enhanced symptom control and better patient-reported outcomes.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"115-121"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between spectra modes of STORZ professional image enhancement system™ and white light cystoscopy in diagnosis of bladder lesions.","authors":"Kunal Vinayak, Subhash V Kotwal, Vikram B Kaushik","doi":"10.4103/iju.iju_221_25","DOIUrl":"10.4103/iju.iju_221_25","url":null,"abstract":"<p><strong>Introduction: </strong>White light cystoscopy (WLC) often fails to detect flat or subtle bladder lesions. Enhanced imaging techniques offer improved detection. The Storz Professional Image Enhancement System (SPIES™) overcomes these limitations and enables concurrent display of WLC and enhanced images, potentially improving tumor detection. In this study, the SPIES™ system was integrated into the diagnostic cystoscopy protocol to compare Spectra™ modes with conventional WLC in the diagnosis of bladder lesions.</p><p><strong>Methods: </strong>This 1-year prospective observational pilot study included 150 patients with suspected or known bladder tumors. Each patient initially underwent WLC, followed by Spectra B™ and Spectra A™ modes. Lesions were mapped according to EAU guidelines; suspicious areas were biopsied or resected for histopathological analysis.</p><p><strong>Results: </strong>WLC showed a sensitivity of 96% and specificity of 45%, with a false positive rate (FPR) of 54.5%. After WLC, Spectra B did not detect any additional lesions, whereas Spectra A identified three additional lesions, including a T2 recurrence. Spectra A™ had 100% sensitivity, but lower specificity (35%) and higher FPR (65%). Spectra A™ detected more lesions than WLC, although the difference was not statistically significant (<i>P</i> = 0.131). The increase in FPR of the Spectra A™ was significant (<i>P</i> = 0.04).</p><p><strong>Conclusions: </strong>Spectra A™ showed higher sensitivity and identified additional cancerous lesions, including one muscle-invasive tumor missed by WLC. However, it also had a significantly higher FPR. While promising, it has its limitations. Spectra A™ shows potential and warrants further research in larger, multicenter trials.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"128-132"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen deprivation therapy and cognitive trajectories in Indian men: A 36-month prospective matched cohort analysis with Addenbrooke's cognitive examination-III.","authors":"Gyvi Gaurav, Shashikant Mishra, Aditya P S Sengar, Ravi Lohani, Anurodh Kumar, Mohd Amir","doi":"10.4103/iju.iju_429_25","DOIUrl":"10.4103/iju.iju_429_25","url":null,"abstract":"<p><strong>Introduction: </strong>Androgen deprivation therapy (ADT), widely used in men with advanced prostate cancer, has been implicated in cognitive decline. Evidence from Western cohorts remains inconsistent, with limited long-term and India-specific data.</p><p><strong>Methods: </strong>We conducted a prospective, observational case-control study between July 2021 and December 2024 with a minimum 36-month follow-up. Men initiating ADT (luteinizing hormone-releasing hormone analogues or bilateral orchidectomy) were compared with a control cohort (benign prostatic hyperplasia or postradical prostatectomy without ADT). Groups were matched for age, baseline Addenbrooke's cognitive examination III (ACE-III) score, G8 frailty score, and gait speed. Cognitive assessments were performed every 6 months using the culturally validated Hindi ACE-III tool. The primary outcome was the change in total ACEII score over 36 months; secondary outcomes included domain-wise changes and correlations with frailty and gait speed.</p><p><strong>Results: </strong>Sixty men were enrolled (30 per group); 21 men received ADT, and 23 served as controls, completing follow-up. Over 36 months, both groups showed modest declines in cognition, with a mean decline of -2.30 ± 1.13 for the ADT group and -1.87 ± 1.62 for the control group (<i>P</i> = 0.638). Domain-wise changes (attention, memory, fluency, language, and visuospatial) were small and statistically similar. Stratified analyses by frailty (G8 ≤ 14 vs. >14) and gait speed (≤0.6 m/s vs. >0.6 m/s) revealed parallel trajectories in both groups, with no effect of ADT.</p><p><strong>Conclusions: </strong>In this 36-month prospective study using a culturally validated tool, ADT was not associated with accelerated global or domain-specific cognitive decline compared to a matched cohort without ADT. These findings suggest that in appropriately selected patients, ADT can be administered without undue concern for disproportionate cognitive deterioration.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"133-138"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new standard for cisplatin-ineligible muscle-invasive bladder cancer: Landmark results from KEYNOTE-905.","authors":"Shashank Agrawal","doi":"10.4103/iju.iju_591_25","DOIUrl":"10.4103/iju.iju_591_25","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"172-173"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteral strictures postureteroscopy: Can we predict or avoid this catastrophic complication?","authors":"Pankaj N Maheshwari, Kartik G Vanani","doi":"10.4103/iju.iju_134_26","DOIUrl":"10.4103/iju.iju_134_26","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"89-91"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of erector spinae plane block and transversus abdominis plane block for postoperative analgesia in laparoscopic donor nephrectomy: A randomized controlled trial.","authors":"Tanvi Bhargava, Divya Srivastava, Tapas Kumar Singh, Abhishek Kumar, Himanshu Vats, Sandeep Sahu","doi":"10.4103/iju.iju_577_25","DOIUrl":"10.4103/iju.iju_577_25","url":null,"abstract":"<p><strong>Introduction: </strong>This randomized parallel group trial was conducted to compare the postoperative analgesic efficacy of erector spinae (ES) plane block and transversus abdominis plane (TAP) plane block in laparoscopic donor nephrectomies.</p><p><strong>Methods: </strong>Sixty voluntary kidney donors received either TAP block (TAP group) or ES plane block (ES group) with 30 ml 0.5% ropivacaine at the end of surgery before tracheal extubation. Postoperatively, all patients received patient-controlled analgesia with intravenous fentanyl. Tramadol 100 mg was administered intravenously as a rescue analgesic. The primary outcome was 24 and 48 h of fentanyl consumption. Static and dynamic pain scores at 30 min, 2^nd, 6^th, 12^th, 24^th, and 48^th h, the requirement for rescue analgesia, incidence of postoperative vomiting, time to ambulation, flatus time, and donor satisfaction were secondary outcomes.</p><p><strong>Results: </strong>There was a significant reduction in fentanyl consumption in the ES group compared to the TAP group at 24 h (429.00 ± 103.06 μg vs. 537.33 ± 187.97 μg) (<i>P</i> = 0.008) and 48 h (280.00 ± 104.79 μg vs. 367.33 ± 170.01 μg, <i>P</i> = 0.020). Static pain scores were significantly reduced in the ES group at all time points except at 48^th h. The ES group had lower dynamic pain scores at all time points; however, the difference was statistically significant only at 30 min (<i>P</i> = 0.022), 6 h (<i>P</i> = 0.027), and 48 h (<i>P</i> = 0.048). Other secondary outcomes were similar in either group.</p><p><strong>Conclusion: </strong>ES plane block results in lower postoperative fentanyl consumption compared to TAP block in living donors undergoing laparoscopic nephrectomy.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"147-153"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embolization of post-partial nephrectomy upper calyceal-perirenal urinary fistula using onyx-34: A novel application of a (pseudo-) liquid embolic agent.","authors":"Maria Vittoria Bazzocchi, Emanuela Giampalma, Antonio Vizzuso, Roberta Gunelli, Matteo Renzulli","doi":"10.4103/iju.iju_505_25","DOIUrl":"10.4103/iju.iju_505_25","url":null,"abstract":"<p><p>Persistent urinary fistulas are a clinically significant complication of nephron-sparing renal surgery, and surgical revisions are difficult procedures with risks, especially in frail patients with relevant comorbidities. We report the first documented case of successful urinary fistula closure using Onyx-34, a nonadhesive liquid embolic agent. A patient with pheochromocytoma, sigmoid adenocarcinoma, and left renal mass developed a persistent urinary leak refractory to conservative treatment. Due to the high risk of surgical revision, the fistulous tract was embolized with Onyx-34 through a percutaneous nephrostomy access, achieving immediate complete clinical resolution of the leak. This case highlights the potential of Onyx-34 as a minimally invasive option for managing complex urinary fistulas in selected patients.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"154-157"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete ureteric disruption following angioembolization for spontaneous retroperitoneal hematoma: A cautionary lesson.","authors":"P Dhineshkumar, Nitin Kekre","doi":"10.4103/iju.iju_559_25","DOIUrl":"10.4103/iju.iju_559_25","url":null,"abstract":"<p><p>Spontaneous retroperitoneal hematoma (SRH) is an uncommon but serious condition, often related to anticoagulant use, vascular fragility, or uncontrolled hypertension. Angioembolization is the preferred treatment for active hemorrhage. We report the case of ureteric necrosis following angioembolization for SRH. A 64-year-old male with multiple comorbidities developed a large SRH requiring embolization. Following the procedure, he developed ureteric necrosis with complete disruption.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"158-160"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticholinergic burden and polypharmacy in hospitalized urology patients: Prevalence and clinical implications.","authors":"Erdem Orman, Hakki Uzun, Gorkem Akça, Eyup Dil, Berat Sonmez, Yakup Kacan","doi":"10.4103/iju.iju_524_25","DOIUrl":"10.4103/iju.iju_524_25","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of polypharmacy and cumulative anticholinergic burden (ACB) in hospitalized patients represents a major concern for drug safety and pharmacological risk management. This study evaluated the prevalence and predictors of polypharmacy and ACB in urology inpatient population, with a focus on pharmacological classification of anticholinergic exposure.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted among 500 consecutive patients admitted to a tertiary urology department between September 2024 and March 2025. Data were extracted from the electronic medical records, including demographics, clinical diagnoses, and prescribed medications. Polypharmacy was defined as ≥5 concurrent medications. Anticholinergic burden was assessed using the Anticholinergic Cognitive Burden (ACB) Scale, with scores ≥3 considered high risk.</p><p><strong>Results: </strong>The cohort had a mean age of 61.7 ± 14.2 years and was predominantly male (81.6%). Polypharmacy was observed in 40.6% of the patients, with significantly higher prevalence in those ≥50 years (47.1% vs. 9.3%; odds ratio = 6.88, 95% confidence interval: 4.09-18.43). Anticholinergic medications were prescribed to 71.4% of the patients, with 25.6% classified as high-risk (ACB ≥3). Pharmacological subgroup analysis revealed frequent exposure to cardiovascular, psychotropic, neurological, and urological agents with anticholinergic properties. Older age was associated with higher ACB scores (<i>P</i> = 0.043). No significant sex differences were observed in the prevalence of polypharmacy (<i>P</i> = 0.06) or ACB burden (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Urology inpatients, particularly older adults, demonstrate high rates of polypharmacy and pharmacologically significant anticholinergic exposure. These findings underscore the importance of pharmacological vigilance, rational prescribing, and deprescribing strategies to mitigate drug-related adverse outcomes in hospitalized population.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"139-146"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment: Magnetic resonance imaging/ultrasound fusion-guided targeted biopsy and ultrasound-guided systematic biopsy for prior negative prostate biopsy: A meta-analysis.","authors":"Lalit Kumar","doi":"10.4103/iju.iju_614_25","DOIUrl":"10.4103/iju.iju_614_25","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"42 2","pages":"106-107"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}