International Braz J Urol最新文献

{"title":"International Brazilian Journal of Urology Congratulates the 2025 Best Reviewers.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2026.01.02","DOIUrl":"10.1590/S1677-5538.IBJU.2026.01.02","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607158","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":"Distribution of Neuroendocrine Cells and Hormone Receptors in the Male Proximal Urethra: Implications for Sensory Function and the Impact of Aging.","authors":"Juan Andrés Venegas, Carlos Gallegos, Paola Ochova, Carlo Lozano, Valentina Pozo, Ivanny Marchant, Pablo Olivero","doi":"10.1590/S1677-5538.IBJU.2025.0402","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0402","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the distribution of neuroendocrine cells in the male penile urethra and the influence of age and estrogen therapy.</p><p><strong>Materials and methods: </strong>A retrospective immunohistochemical cohort study was conducted on 26 penile urethras obtained during feminizing genitoplasty. Three anatomical regions were analyzed: bulbar, distal, and glans urethra. Neuroendocrine cells were identified by double immunohistochemistry and quantified as chromogranin A-positive cells per mm² of epithelium.</p><p><strong>Results: </strong>Patients were divided according to estrogen exposure: Group 1 (n=12, median age 23.5 years, estrogen 5.5 years) and Group 2 (n=14, median age 43.0 years, estrogen 18.0 years). A clear gradient of neuroendocrine cell density was observed, with the bulbar urethra showing the highest values compared to distal urethra and glans. Group 2 had significantly higher bulbar urethral cell density than Group 1 (p<0.005). A negative correlation between age and bulbar density was observed.</p><p><strong>Conclusions: </strong>This study provides evidence of a neuroendocrine cell gradient in the human male urethra, concentrated in the bulbar region. Cell density declines with age but is preserved by long-term estrogen therapy. These findings underscore the bulbar urethra as a key sensory structure that should be preserved during surgery and suggest that hormone therapy may mitigate age-related sensory decline.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208112","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":"Acute Kidney Injury Following Mini Percutaneous Nephrolithotomy for Renal Stones: predictors and Follow-up Evaluation in Real-life Setting.","authors":"Federica Passarelli, Ludovico Maria Basadonna, Fabio Ciamarra, Edoardo Bonacina, Giorgio Graps, Edoardo Sorba, Valentina Parolin, Gianpaolo Lucignani, Francesco Ripa, Stefano Paolo Zanetti, Fabrizio Longo, Elisa De Lorenzis, Giancarlo Albo, Emanuele Montanari, Luca Boeri","doi":"10.1590/S1677-5538.IBJU.2025.0453","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0453","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prevalence, predictors, and progression of acute kidney injury (AKI) in patients undergoing mPCNL for nephrolithiasis.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed data from 569 patients who underwent mPCNL at a single tertiary academic center (01/2016-10/2024). AKI was defined per KDIGO criteria as sCr increase >0.3 mg/dL or ≥1.5× baseline. Stone-free status was no residual stones on CT at 3-month follow-up. Complications were classified using the modified Clavien system. Kidney function was reassessed 30-90 days post-op. Descriptive statistics, logistic regression, and Cox regression were applied.</p><p><strong>Results: </strong>Median (IQR) age and stone volume were 57 (48-66) years and 2.1 (0.9-4.2) cm³. Median preoperative sCr and operative time were 0.9 (0.7-1.1) mg/dL and 90 (73-120) minutes. Post-mPCNL, 40 patients (7.0%) developed AKI. Complications occurred in 138 (24.2%) patients; 449 (78.9%) were stone-free. AKI patients had higher CCI (1.3 vs. 0.5, p=0.04), pre-op sCr (1.1 vs. 0.8 mg/dL, p<0.01), stone volume (5.7 vs. 2 cm³, p=0.02), and longer operative time (130 vs. 90 min, p=0.01). Complications were more frequent in AKI patients (42.5% vs. 22.8%, p=0.01). At multivariate analysis, operative time (OR 1.1, p=0.03), pre-op sCr (OR 3.8, p=0.001), and early complications (OR 2.5, p=0.02) were independently associated with AKI. AKI persisted in 9 (22.5%) patients, mainly those with complications (88.9% vs. 38.7%, p=0.01). On Cox analysis, lower BMI (HR 0.8, p=0.02) and absence of complications (HR 0.3, p=0.01) predicted faster AKI recovery.</p><p><strong>Conclusion: </strong>Acute kidney injury remains a clinically significant complication following mPCNL.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208028","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":"Robot-Assisted Bladder Neck Reconstruction in Refractory Vesicourethral Anastomot-ic Stenosis - A Single-Center Experience from a Specialized Urinary Tract Repair and Reconstruction Center.","authors":"Jianwen Huang, Changhao Hou, Song Li, Xiaoyong Hu, Ranxing Yang, Ying Wang, Nailong Cao, Jiong Zhang, Lujie Song, Qiang Fu","doi":"10.1590/S1677-5538.IBJU.2025.0385","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0385","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of robotic-assisted bladder neck reconstruction in patients with refractory vesicourethral anastomotic stenosis (VUAS) following radical prostatectomy (RP) or radical cystectomy (RC) with orthotopic neobladder (ONB) reconstruction.</p><p><strong>Methods: </strong>The clinical data from patients with VUAS who underwent robot-assisted bladder neck reconstruction at our center from August 2022 to February 2025 were retrospectively analyzed. The minimum postoperative follow-up period was 3 months, and bladder neck patency was defined as either the passage of a F16 flexible cystoscope or a maximum urinary flow rate (Qmax)>15 mL/s.</p><p><strong>Results: </strong>A total of 27 patients were analyzed, including 25 with a history of RP and 2 with a history of RC with ONB reconstruction. The median operative time was 210 min (interquartile range [IQR]:168-259), with a median estimated blood loss of 152 mL (IQR: 80-255) and a median postoperative hospital stay of 3.5 d (IQR: 3-6 d). At the median follow-up of 11 months (IQR: 3-34), 20 patients (74.1%) achieved patent reconstruction and 9 patients (75%) remained continent in 12 patients without preexisting stress urinary incontinence (SUI) at last follow-up. Postoperative complications occurred in five patients (18.5%), including two cases of Clavien-Dindo grade Ӏ and three cases of grade ӀӀ.</p><p><strong>Conclusions: </strong>Robotic-assisted bladder neck reconstruction represents a safe and effective surgical option with high patency and low de novo SUI rates for refractory VUAS following RP or RC with ONB reconstruction.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304165","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":"Bridging Methodology and Clinical Relevance: Toward More Robust Evidence for Antiox-idant Therapy in Male Infertility.","authors":"Shengyi Chen, Yuekun Fang, Bin Cheng","doi":"10.1590/S1677-5538.IBJU.2025.0407","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0407","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785782","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":"Use of Dynamic Magnetic Resonance of the Urethra in Surgical Planning of Vesicourethral Anastomotic Stenosis Urethroplasty.","authors":"Gustavo Fiedler, André Guilherme Cavalcanti, Leonardo Kayat Bittencourt, Suzan Menasce Goldman","doi":"10.1590/S1677-5538.IBJU.2025.0264","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0264","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of dynamic Magnetic Resonance of the Urethra (d-MRU) on postoperative results and their agreement with intraoperative findings in patients with urethral stricture after radical prostatectomy.</p><p><strong>Methods: </strong>Forty-eight male patients (mean age 65.2 ± 8.1 years) with vesicourethral anastomotic stenosis (VUAS) after radical prostatectomy confirmed by cystoscopy were evaluated using dynamic MRU and cystourethrography (CUG). They were divided into two groups: d-MRU and CUG. Patients in the d-MRU group were evaluated using a new MRI protocol: urethral filling with lidocaine gel and distal urethral obstruction with sterile gas tourniquet; MR urethrography including axial T1-weighted images, coronal space, sagittal T2-weighted, axial T2-weighted, sagittal maximum intensity projection (MIP) with urographic effect, voiding sagittal MIP, and T1-weighted with fat saturation (T1 fat-sat) before and after gadolinium enhancement. Dynamic imaging acquisition with motion images was performed during voiding.</p><p><strong>Results: </strong>No significant difference in restenosis rates was observed between the D-MRI and UCG groups (5.6% vs. 16.7%, respectively; p = 0.261), but a significant difference in vascular preservation (94.4% vs. 63.3%, p=0.016). We found consistent dynamic MRU and intraoperative measurements of VUAS. Intraclass correlation coefficients showed satisfactory to excellent levels of agreement between the two imaging modalities and a strong correlation of dynamic MRU and intraoperative findings. Additionally, the Bland-Altman analysis revealed an agreement bias close to zero.</p><p><strong>Conclusions: </strong>Dynamic MRU is a safe and appropriate evaluation method that can provide guidance for surgical treatment planning in patients with VUAS after radical prostatectomy.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066193","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":"Telesurgery in Brazil: Opportunities, Responsibilities, and the Path Ahead.","authors":"Marcio Covas Moschovas, Alexandre Pompeo, Gustavo Cardoso Guimarães, Renato Almeida Rosa de Oliveira, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2025.0517","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0517","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066172","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":"Editorial Comment: Two-stage Fowler-Stephens orchidopexy in management of undescended testes: Is it time for a change? A UK multi-centre retrospective study.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.9919","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9919","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304106","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":"Portrait of a Series of Patients with Pheochromocytoma/Paraganglioma from a Reference Center in Brazil: Relevance of Prior Background Features.","authors":"José Viana Lima, Nilza M Scalissi, Suzan M Goldman, Claudio E Kater","doi":"10.1590/S1677-5538.IBJU.2025.0094","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0094","url":null,"abstract":"<p><strong>Purpose: </strong>Pheochromocytomas (Pheo) and paragangliomas (PGL) are catecholamine-secreting tumours, whose functionality is confirmed by elevated plasma (Pl) and/or 24-h urinary (Ur) metanephrines (MN). Relevance of prior background features were reviewed in a large cohort of patients with Pheo and PGL.</p><p><strong>Material and methods: </strong>We reviewed clinical, hormonal, and imaging aspects of 116 patients studied prospectively: 93 Pheo; 22 PGL; one Pheo plus PGL.</p><p><strong>Results: </strong>Twenty-five % PPGL were discovered incidentally. Systemic arterial hypertension (SAH) was present in 81% (43% on stage 3), whereas 9.5% were prehypertensive and 9.5%, normotensive. SAH plus paroxysms occurred in 31 (32.9%) patients, being exclusively sustained in the remaining; 26 (28%) had resistant SAH. Orthostatic hypotension was seen in 65% of patients. Pl/Ur MN and normetanephrine (NMN) were compared to those of a positive (56 functioning PPGL) and a negative control group (654 subjects with normal MN/NMN). Total and fractionated Ur MN were elevated in 94% PPGL patients. Cut-off values of 885 mcg/24-h for Ur MN, and of 1.5 nmol/L for Pl MN identified functioning lesions with 100%/100% sensitivity and 93%/97% specificity, respectively. MRI detected 56% right-side Pheo, 25% on the left, and 19% bilateral; PGL were 56.5% (13/23) retroperitoneal and 43.5%, cervical (10/23). Right-side Pheo were larger (5.8 cm) than left-side ones (3.7 cm), but retroperitoneal (6.5 cm) and neck PGL (6.9 cm) were similar. Tumour size positively correlated with total Ur MN.</p><p><strong>Conclusions: </strong>in this large cohort of PPGL patients we highlighted relevant aspects of SAH, the frequently overlooked manifestation of orthostatic hypotension, common incidental presentation, significant tumour size/hormonal production.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12563923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776732","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":"Performance of ChatGPT and DeepSeek in the Management of Postprostatectomy Urinary Incontinence","authors":"Vicktor Bruno Pereira Pinto, Romullo José Costa Ataídes, Lucas Antônio Pereira do Nascimento, Cristiane de Barros Gaspar, Priscila Ferreira Alves, Magnum Adriel Santos Pereira, Manoel José de Macedo, Willian Carlos Nahas, José de Bessa, Cristiano Mendes Gomes","doi":"10.1590/S1677-5538.IBJU.2025.0325","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0325","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) continues to evolve as a tool in clinical decision support. Large language models (LLMs), such as ChatGPT and DeepSeek, are increasingly used in medicine to provide fast, accessible information. This study aimed to compare the performance of ChatGPT and DeepSeek in generating recommendations for the management of postprostatectomy urinary incontinence (PPUI), based on the AUA/SUFU guideline.</p><p><strong>Materials and methods: </strong>A total of 20 questions (10 conceptual and 10 case-based) were developed by three urologists with expertise in PPUI, following the AUA/SUFU guideline. Each question was submitted in English using zero-shot prompting to ChatGPT-4o and DeepSeek R1. Responses were limited to 200 words and graded independently as correct (1 point), partially correct (0.5), or incorrect (0). Total and domain-specific scores were compared.</p><p><strong>Results: </strong>ChatGPT achieved 19 out of 20 points (95.0%), while DeepSeek scored 14.5 (72.5%; p = 0.031). In conceptual questions, scores were 9.0 (ChatGPT) and 8.0 (DeepSeek; p = 0.50). In case-based scenarios, ChatGPT scored 10.0 versus 6.5 for DeepSeek (p = 0.08). ChatGPT outperformed DeepSeek across all guideline domains. DeepSeek made critical errors in the treatment domain, such as recommending a male sling for radiated patients.</p><p><strong>Conclusion: </strong>ChatGPT demonstrated superior performance in providing guideline-based recommendations for PPUI. However, both models should be used under expert supervision, and future research is needed to optimize their safe integration into clinical workflows.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976142","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}