International Braz J Urol最新文献

{"title":"Scrotal Ultrasound in the Infertile Male-A Practical Compass for the Urologist.","authors":"Sandro C Esteves","doi":"10.1590/S1677-5538.IBJU.2025.9920.1","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9920.1","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Brazilian Version of the Cambridge Renal Stone Patient-Reported Out-come Measure (Br-CReSP) versus a Generic Questionnaire for Assessing Health-Related Quality of Life in Nephrolithiasis.","authors":"Alexandre Danilovic, Daniel Gabriele Sucupira, Oliver Wiseman, Elaine Brasil, Fabio Cesar Miranda Torricelli, Giovanni Scala Marchini, Carlos Batagello, Rodrigo Perrela, Fabio Carvalho Vicentini, William C Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2025.0553","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0553","url":null,"abstract":"<p><strong>Purpose: </strong>No validated tool specifically assesses health-related quality of life (HRQoL) in Brazilian patients with kidney stones. The Cambridge Renal Stone Patient-Reported Outcome Measure (CReSP) is a self-administered questionnaire that evaluates the impact of kidney stones on patients' QoL over the preceding seven days. This study aimed to translate the CReSP into Portuguese, validate it, and compare it with the validated generic SF-12 questionnaire.</p><p><strong>Materials and methods: </strong>The CReSP questionnaire was translated into Portuguese following Guillemin's guidelines. Patients with and without kidney stones completed the Brazilian version of the CReSP (Br-CReSP) and SF-12 questionnaires. Internal consistency, test-retest reliability, discriminant validity, and convergent validity with SF-12 components were evaluated. Logistic regression assessed the discriminant capacity of Br-CReSP and SF-12 components for nephrolithiasis.</p><p><strong>Results: </strong>One hundred patients completed both questionnaires. Internal consistency was high across all domains and the total score (Cronbach's α = 0.92). Test-retest reliability demonstrated strong correlations for all domains and the total score (ICC = 0.94). Discriminant validity was evidenced by significant differences between patients with and without kidney stones, with large effect sizes. Convergent validity was shown by significant inverse correlations between the Br-CReSP and SF-12 (p < 0.001). The Br-CReSP outperformed PCS-12 and MCS-12 in predicting nephrolithiasis (AUC = 0.91 vs. 0.84 and 0.73, respectively).</p><p><strong>Conclusions: </strong>The validated Br-CReSP outperforms SF-12 in assessing HRQoL in Brazilian patients with kidney stones.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Suction Ureteral Access Sheath Technique in Retrograde Intrarenal Surgery (RIRS): Tips, Tricks & Troubleshooting.","authors":"Giovanni Scala Marchini, Alexandre Danilovic, Fábio Cesar Miranda Torricelli, Fábio Carvalho Vicentini, Carlos Alfredo Batagello, Rodrigo Perrella, Pedro Antonio Araújo Simões, Alexandre Gilberto Silva, William Carlos Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2025.0535","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0535","url":null,"abstract":"<p><strong>Introduction: </strong>Suction ureteral access sheaths (FANS, S-UAS) are reshaping retrograde intrarenal surgery (RIRS) by improving stone-free rates and reducing complications compared to traditional UAS (1-5). Since their use requires significant technical adjustments with limited standardization, we present an instructional video detailing setup, operative choreography, and troubleshooting.</p><p><strong>Methods: </strong>Single-center instructional case from a tertiary unit. Index patient: 67-year-old man with a 25-mm right pelvic stone (1560 HU; ~3500 mm³). Preoperative considerations included selective prior stenting and off-label α-blockers. We typically use 10/12 or 11/13 Fr suction UAS with 7.5-8.5 Fr flexible ureteroscopes. Setup: pressurized irrigation to the ureteroscope; lateral suction port connected to a labeled collector cup via a vacuum regulator, creating a closed-loop, pressure-aware system. Under fluoroscopy, the sheath is positioned above the ureteropelvic junction (UPJ) with careful advancement into the target calyx. Laser strategy combines dusting and fragmentation with suction. Fragments are evacuated through coordinated suction bursts and slow scope withdrawal. Final inspection defines stent placement and dwell.</p><p><strong>Results: </strong>Operative time was 115 min, with 25 min of laser use. POD-1 CT confirmed stone-free status. The patient was discharged after 24 h, and the double-J stent with string was removed on day 5. The high-definition video illustrates connections, target pressures, inflow/outflow rules, and provides concise troubleshooting algorithms for common issues: impassable UPJ (use as conventional UAS), friction/kinks, clogging, and system collapse (increase inflow, reduce suction, or reopen outflow).</p><p><strong>Conclusion: </strong>A standardized suction-UAS technique is feasible and reproducible, optimizing visualization, fragment clearance, pressure control, and safety during RIRS for large stones (6-8). Standardization videos such as this may enhance training, support wider adoption, and improve consistency of outcomes.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life in Patients with Ureteral Stones: Translation and Validation of the Brazilian Version of the Cambridge Ureteral Stone PROM (Br-CUSP).","authors":"Alexandre Danilovic, Daniel Gabriele Sucupira, Oliver Wiseman, Fabio Cesar Miranda Torricelli, Giovanni Scala Marchini, Carlos Batagello, Rodrigo Perrela, Fabio Carvalho Vicentini, William C Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2025.0551","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0551","url":null,"abstract":"<p><strong>Purpose: </strong>There is currently no validated instrument in Brazil specifically designed to assess the quality of life (QoL) of patients with ureteral stones. The Cambridge Ureteral Stone Patient-Reported Outcome Measure (CUSP) is a self-administered questionnaire that evaluates the QoL impact of ureteral stones over the preceding seven days. This study aimed to translate, culturally adapt, and validate the CUSP for Brazilian Portuguese (Br-CUSP) for clinical and research applications.</p><p><strong>Materials and methods: </strong>The CUSP questionnaire was translated into Portuguese according to Guillemin's cross-cultural adaption guidelines. Patients with and without ureterolithiasis completed both the Br-CUSP and SF-12 questionnaires. Psychometric validation included assessment of internal consistency, test-retest reliability, convergent validity, and discriminant validity.</p><p><strong>Results: </strong>A total of 156 participants completed both questionnaires. No inconsistencies emerged during univariate analysis. Confirmatory factor analysis supported the six-factor model with satisfactory fit indices. All factor loadings exceeded 0.50. Internal consistency was high across all domains (Cronbach's α = 0.72 - 0.98; McDonald's ω = 0.73 - 0.98). Test-retest reliability demonstrated strong temporal stability. Inter-domain correlations (Spearman's p = 0.45 - 0.82) supported structural coherence. Convergent validity was confirmed through inverse correlations with SF-12 scores. Discriminant validity was demonstrated by significant score differences between patients with and without ureteral stone, with large effect sizes.</p><p><strong>Conclusions: </strong>The Brazilian Cambridge Ureteral Stone Patient-Reported Outcome Measure is a valid, reliable tool for assessing health-related quality of life in Brazilian patients with ureteral stones. Its implementation can enhance both clinical assessment and research into patient-centered outcomes in urolithiasis.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculous Chronic Prostatitis: a Neglected Disease.","authors":"André Avarese Figueiredo, Augusto de Azevedo Barreto, Victor Silvestre Soares Fanni","doi":"10.1590/S1677-5538.IBJU.2025.0521","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0521","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Cancer Immunotherapy in 2025: ALBAN, CREST, POTOMAC, and the Winner Is BCG!","authors":"Leonardo O Reis","doi":"10.1590/S1677-5538.IBJU.2025.9921","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9921","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micropenis in Children and Adolescents: A Narrative Review.","authors":"Edson da Silva Salvador, Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.0648","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0648","url":null,"abstract":"<p><strong>Purpose: </strong> To summarize current evidence on the etiology, diagnostic approach, management strategies, and outcomes of micropenis in children and adolescents.</p><p><strong>Materials and methods: </strong>A narrative review was performed using PubMed/MEDLINE (October 2025) with the search terms (Micropenis OR Microphallus OR \"Small Penis\") AND (Children OR Youth OR Adolescents). From 707 records screened, 36 studies were selected based on methodological quality and relevance to clinical practice.</p><p><strong>Results: </strong>Micropenis is a clinical sign frequently associated with underlying endocrinopathies, particularly Congenital Hypogonadotropic Hypogonadism (CHH). Accurate diagnosis relies on standardized Stretched Penile Length (SPL) assessment, recently optimized by the Stretched Penile Length INdicator Technique (SPLINT). Use of population-specific SPL nomograms is critical for diagnostic reliability. Testosterone therapy remains the primary treatment modality and demonstrates greatest efficacy in early infancy, promoting significant penile growth and generally favorable functional outcomes. Spontaneous catch-up growth during puberty has been reported in select cases. Current evidence supporting surgical interventions in children and adolescents is limited, heterogeneous, and associated with inconsistent long-term results; thus, surgery should not be considered first-line therapy. High-quality long-term outcome data and randomized placebo-controlled trials are lacking.</p><p><strong>Conclusions: </strong> Standardized SPL measurement and appropriate nomogram use are essential for accurate diagnosis. Early hormonal therapy, especially in CHH-associated micropenis, appears to yield optimal functional and psychosocial outcomes. Expectant management may be appropriate in selected clinical scenarios. Surgical techniques remain controversial, with insufficient evidence to recommend routine use. Further well-designed prospective studies, including randomized placebo-controlled trials, are needed to define long-term outcomes and guide clinical decision-making.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Basics: Best Practices in Scrotal Ultrasound for the Infertile Male.","authors":"Francesco Lotti","doi":"10.1590/S1677-5538.IBJU.2025.9920","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9920","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Retroperitoneal Lymph Node Dissection in a Challenging Post-Chemotherapy Case.","authors":"Willy Baccaglini, Gabriel Chahade Sibanto Simões, Julio Calderón, Nicolle Christofe, Luis G Medina, Paulo Priante Kayano, Gustavo Lemos, Arie Carneiro","doi":"10.1590/S1677-5538.IBJU.2025.0466","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0466","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic retroperitoneal lymph node dissection (RPLND) has emerged as a minimally invasive alternative for the management of testicular germ cell tumors, offering reduced morbidity and faster recovery when performed in experienced centers (1-3). However, post-chemotherapy cases remain technically demanding. We present a case of robotic RPLND performed for a bulky residual mass following systemic treatment.</p><p><strong>Methods: </strong>A 23-year-old male with no comorbidities underwent right orchiectomy for clinical stage IIC non-seminomatous germ cell tumor (60% yolk sac, 20% embryonal carcinoma, 20% post-pubertal teratoma), followed by three cycles of BEP chemotherapy. Tumor markers normalized, but imaging revealed a persistent 5.4-cm interaortocaval mass. Robotic RPLND was carried out using four robotic ports and one 12-mm assistant port. The procedure included a complete bilateral template dissection (paraaortic, interaortocaval, and paracaval), en bloc tumor removal, and meticulous sharp and blunt dissection using advanced bipolar energy.</p><p><strong>Results: </strong>Operative time was 300 minutes, with minimal blood loss (50 mL) and no intraoperative complications. The bulky lesion was successfully resected with excellent anatomical exposure, despite significant tumor adherence to the aorta. The patient was discharged on postoperative day one and resumed normal activities within two weeks. Pathology revealed teratoma in 1 of 34 resected lymph nodes. At 6-month follow-up, he remained disease-free, with normal tumor markers, preserved renal function, and no complications.</p><p><strong>Conclusion: </strong>This case demonstrates the feasibility of robotic RPLND for large post-chemotherapy residual masses. The robotic platform enables precise dissection even in challenging settings, with favorable perioperative and oncologic outcomes. Centralized expertise and standardized technique are essential to achieve optimal results (1, 4-6).</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Peer Review: Preserving Integrity in the Pursuit of Efficiency.","authors":"José de Bessa, Cristiano Mendes Gomes","doi":"10.1590/S1677-5538.IBJU.2025.0538","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0538","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}