The French journal of urology最新文献

{"title":"Synthetic mid urethral slings in female spina bifida patients with stress urinary incontinence: is it worth it?","authors":"Alicia Blondeau, Samia Laraqui, Goncalo Mendes, Juliette Hascoet, Camille Haudebert, Charlène Brochard, Claire Richard, Caroline Voiry, Laurent Siproudhis, Krystel Nyangoh Timoh, Andrea Manunta, Emmanuelle Samson, Benoit Peyronnet","doi":"10.1016/j.fjurol.2025.102938","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102938","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to report the outcomes of synthetic midurethral slings (MUS) in female patients with spina bifida and stress urinary incontinence (SUI).</p><p><strong>Methods: </strong>All female patients with spina bifida who were seen at a national referral center between 2007 and 2021 and who had a history of MUS for SUI were included in a retrospective study. The primary outcome of interest was the continence status at 1 year as per patients' subjective perception categorized as complete continence (no pads), improved continence, unchanged or worsened SUI.</p><p><strong>Results: </strong>Out of 339 female spina bifida patients; 11 patients had undergone a MUS insertion and were included for analysis (3.2%). The median age was 30 years (range 19-52 years). The majority of patients were nulliparous (63.6%). There were four post-operative complications (36.4%) including one chronic urinary retention resulting in complete mesh removal at 3 months (Clavien grade 3B). At one year, the three patients fully continent at three months were still fully continent at one year (27.3%) while three had improved continence (27.3%) and five had unchanged continence (45.5%). After a median follow-up of 102 months, only one patient was still fully continent (9.1%) and three patients had still improved continence (27.3%). Five patients (45.5%) underwent a subsequent anti-incontinence procedure. The only adverse predictor of improved/complete continence at 1 year was a sacral neurological level (OR=0.05; p=0.03).</p><p><strong>Conclusion: </strong>MUS in women with spina bifida and SUI appears to be safe but less effective than in the non-neurogenic population which may be explained by different underlying pathophysiological mechanisms. These findings question the relevance of this treatment option in these complex population, especially in the current mesh controversy era.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102938"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719317","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":"Training Fellows in Robot-Assisted Partial Nephrectomy Under Expert Surgeon Supervision: Insights from a Single-Center Study.","authors":"Erica Gallner, Franck Bruyère, Ali Bourgi","doi":"10.1016/j.fjurol.2025.102928","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102928","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted partial nephrectomy (RAPN) is a preferred technique for treating localized renal tumors due to its potential to preserve renal function. This study aimed to assess the impact of young surgeon's training on perioperative outcomes of RAPN.</p><p><strong>Methods: </strong>This retrospective study described the outcomes of RAPN performed by surgical fellows under the supervision of experienced surgeons at a single center. A total of 298 RAPN procedures were analyzed, comparing 130 performed by fellows (Junior group) and 168 by expert surgeons (Senior group).</p><p><strong>Results: </strong>While operative time (203 vs. 130 minutes) and warm ischemia time (17 vs. 15 minutes) were longer in Junior group, there were no significant differences in intraoperative blood loss, postoperative complications, or positive surgical margins between the two groups.</p><p><strong>Conclusion: </strong>These results suggest that with proper supervision, fellows can safely perform RAPN with outcomes comparable to those of more experienced surgeons.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102928"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719344","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":"Prescribing androgen deprivation therapy for prostate cancer: results of a French questionnaire survey.","authors":"Théophile Pajot, Jonathan Olivier, Denis Seguier, Arnauld Villers, Nicolas Penel","doi":"10.1016/j.fjurol.2025.102930","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102930","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the management of adverse effects at the initiation and during follow-up of androgen deprivation therapy (ADT) for prostate cancer (PCa), by French urologists, oncologists, and radiotherapists, including treatments with luteinizing hormone-releasing hormone (LHRH) agonists or antagonists and androgen receptor pathway inhibitors (ARPIs).</p><p><strong>Methods: </strong>A 23-question questionnaire was sent to French oncologists, radiotherapists and urologists via various regional and national networks. Responses were collected between February and July 2024 using a Google Form. A descriptive analysis was performed.</p><p><strong>Results: </strong>Among the 133 respondents, 27.1% were urologists, 36.1% oncologists, and 36.8% radiotherapists, with a mean age of 38.6 years. A Likert scale was used to assess the importance of different examinations before initiating ADT, ranging from 1 (not important) to 5 (very important). Lipid profile had the highest mean score (4.12), while height measurement had the lowest (2.18). Cardiologist referral for metastatic PCa patients undergoing ADT was not systematic, with 12.7% of respondents never referring these patients to a cardiologist. Darolutamide was the least prescribed ARPI (52/133), whereas abiraterone acetate (100/133) and enzalutamide (102/133) were most commonly prescribed. Key barriers to prescribing ARPIs included cardiological follow-up, drug interactions, liver and skin toxicity, and a lack of experience with the drug.</p><p><strong>Conclusion: </strong>Pre-therapeutic assessment and follow-up of patients undergoing ADT seems to vary from one prescriber to another. These findings highlight opportunities to optimize treatment, particularly through medication reconciliation programs, which enhance the safe and appropriate use of ADT in PCa.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102930"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719312","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":"Bladder cancer prevalence and diagnostic test accuracy: French results from the IDENTIFY study.","authors":"Aleksandra Szostek, Sinan Khadhouri, Kevin M Gallagher, Kenneth R MacKenzie, Taimur T Shah, Chuanyu Gao, Eleanor F Zimmermann, Veeru Kasivisvanathan, Evanguelos Xylinas, Idir Ouzaid, Jonathan Olivier, Alexandre Schneider, Florian Bardet, Audrey Uzan, Cédric Lebacle, Camille Ternynck, Gautier Marcq","doi":"10.1016/j.fjurol.2025.102935","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102935","url":null,"abstract":"<p><strong>Introduction: </strong>The IDENTIFY study aimed to assess the international prevalence of bladder cancer in patients referred to urologists for evaluation of haematuria or suspicion of bladder cancer. The primary objective of this analysis was to report the French data from IDENTIFY : prevalence, diagnostic performance of urologists during cystoscopy, and diagnostic performance of the initial evaluation with ultrasound and CT scan.</p><p><strong>Materials and methods: </strong>A prospective study was conducted in 6 French centers from December 2017 to December 2018. All patients (>16 years) referred for cystoscopy (microscopic (NVH) / macroscopic (VH) haematuria or clinical suspicion of bladder cancer) were included. Patients with a previous diagnosis of urological cancer were excluded. Diagnostic performance was assessed by calculating sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV).</p><p><strong>Results: </strong>The IDENTIFY study included 261 French patients (10,896 patients included internationally). The overall prevalence of bladder cancer was 18% (95% CI 13.4 - 22.7). Regarding diagnostic performance, sensitivities were estimated at 70.6% (95% CI 48.9 - 92.3) and 58.6% (95% CI 40.7 - 76.6) for ultrasound and CT scan, respectively. Specificities were 95.5% (95% CI 90.6 - 100) and 97.7% (95% CI 95.1 - 100). Urologist performance in predicting stage, grade, and presence of CIS was: Se 85.7% (95% CI 59.8 - 100) and Sp 90.6% (95% CI 80.5 - 100) for stage prediction, Se 80.8% (CI 95% 65.6 - 95.9) et Sp 38.5% (CI 95% 12.0 - 64.9) for grade prediction, and Se 80% (95% CI 44.9 - 100) and Sp 88.6% (95% CI 78 - 99.1) for CIS prediction.</p><p><strong>Conclusion: </strong>Nearly one in five patients referred for cystoscopy to a French urologist has bladder cancer. French urologists' cystoscopic data accurately predict stage, grade, and CIS presence in over 80% of cases. French data are consistent with international findings.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102935"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719341","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":"Letter to the Editor: \"Forgotten double J stents: Correlation between KUB score and complexity of management\".","authors":"Ahmet Burak Yilmaz","doi":"10.1016/j.fjurol.2025.102939","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102939","url":null,"abstract":"","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102939"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719310","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":"Effect of Transcutaneous tibial nerve stimulation on sexual function in women with multiple sclerosis.","authors":"Théa Raphaël, Maëlys Teng, Camille Chesnel, Magdaline Vivier, Camille Noel, Gerard Amarenco, Claire Hentzen","doi":"10.1016/j.fjurol.2025.102937","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102937","url":null,"abstract":"<p><strong>Aims: </strong>The aim was to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) on sexual function in women with multiple sclerosis (WwMS) reporting overactive bladder symptoms.</p><p><strong>Methods: </strong>All WwMS who underwent 12 to 24 weeks of TTNS for overactive bladder, and pre- and post-treatment assessment between June 2020 and October 2022 were retrospectively included. The effect of TTNS on sexual dysfunction was assessed by the Female Sexual Function Index (FSFI) global score and subdomains, before and after the stimulation. Other data collected were the Sexual Expectation Assessment in Multiple Sclerosis (SEA-MS-F) score to assess patients' expectations regarding the management of sexual disorders, the Expanded Disability Status Scale (EDSS) score, and the Patient Global Impression of Improvement (PGI-I) to assess patient satisfaction with TTNS regarding overactive bladder symptoms.</p><p><strong>Results: </strong>Fifty-eight patients were included (mean age 47.4 ± 11.5). According to the FSFI score at the initial assessment, 38 patients (65%) had sexual dysfunction. There was no significant difference in the global FSFI score after a mean of 15 weeks of stimulation (p=0.17) or in the different domains of sexual dysfunction (FSFI sub-scores). A minor improvement in the FSFI total score in the group with a lower EDSS score (<6) was found, with a median difference of 0.95 [0; 3.75] (p=0.04).</p><p><strong>Conclusion: </strong>TTNS showed no significant improvement in global sexual function or specific domains in WwMS and overactive bladder. Further studies targeting more specifically population interested in a dedicated treatment for sexual dysfunction could be valuable.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102937"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719343","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":"Epidemiology of urinary stone composition in the Southwest of France: a 23-year single-center retrospective study.","authors":"Manon Lesain, Jean-Marc Blouin, Renaud De la Faille, Vincent Estrade, Jérôme Harambat, Emmanuel Richard","doi":"10.1016/j.fjurol.2025.102936","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102936","url":null,"abstract":"<p><strong>Introduction: </strong>Urolithiasis is a frequent disease whose prevalence is increasing worldwide. The epidemiological study of urinary stone composition allows to understand the lithogenic processes and makes it possible to improve individual management and orienting public health policies to prevent stone disease.</p><p><strong>Material and methods: </strong>We retrospectively report a series of 6825 urinary stones collected in single university hospital of southwest France between 1999 and 2022. Stone composition was determined by infrared spectroscopy and data were analyzed according to period, age, sex and anatomical location.</p><p><strong>Results: </strong>Our results indicated an average age of 49.5 years and a male/female sex ratio of 1.99 which tended to decrease over time. In adults, calcium oxalate is the predominant compound, and urolithiasis was preferentially located in the upper urinary tract. Uric acid is more common in bladder stones from men after 50 years. Calcium phosphates (especially carbapatite) and struvite were the main constituents of bladder stones from young women aged 20 to 30 years, pointing particularly to an infectious process. Drug-induced stones are uncommon, and essentially composed of anti-infective drugs. In children, urolithiasis predominated in the kidney and young boys aged 6 to 10 years were mostly affected with urinary stones formed mainly of carbapatite, whereas weddellite was the main compound identified in girls.</p><p><strong>Conclusion: </strong>Our data highlight the composition of urinary stones according to age, gender and anatomic localization over a large two decades period. These results complete epidemiological data previously published in large-scale national studies in France and across the world.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102936"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719309","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":"Short CIAFU recommendations on the screening and management of asymptomatic bacteriuria in immunocompromised patients.","authors":"C Le Goux, K Bouiller, A Dinh, A Sotto, M Vallée","doi":"10.1016/j.fjurol.2025.102941","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102941","url":null,"abstract":"<p><strong>Introduction: </strong>Immunosuppression refers to a functional or quantitative reduction in immune defenses, resulting in a diminished ability to combat microbial pathogens. Immunocompromised patients are at increased risk of severe infections, associated with elevated morbidity and mortality.In routine clinical practice, urine cultures are often performed systematically in patients considered at risk of infection, regardless of urinary symptoms, with the aim of detecting and subsequently treating potential asymptomatic bacteriuria.This study aimed to assess the clinical relevance of screening for and potentially treating asymptomatic bacteriuria in immunocompromised individuals.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted using PubMed and Medline, without restrictions on language or year of publication. This was complemented by an exploration of the scientific grey literature, including expert reports and guidelines from professional societies. Studies were selected using the following keywords: antibiotic treatment, urinary tract infection, asymptomatic bacteriuria, bacteriuria, pyelonephritis, cystitis, immunodeficiency, diabetes, renal transplant, neurogenic bladder, cirrhosis, pregnancy, and antimicrobial resistance. All abstracts and full-text articles were reviewed. The synthesis of the findings was subsequently evaluated by members of the CIAFU expert committee, who formulated the most consensual recommendation possible.</p><p><strong>Results: </strong>Across the reviewed literature, no clear benefit was identified in screening for or treating asymptomatic bacteriuria in immunocompromised patients.</p><p><strong>Conclusion: </strong>It is not recommended to screen for or treat asymptomatic bacteriuria in immunocompromised patients, except in specific, well-established scenarios. Treating asymptomatic bacteriuria does not reduce infection risk; rather, it increases the likelihood of adverse effects and contributes to the development of antimicrobial resistance, with its associated morbidity and mortality.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102941"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719316","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":"Relugolix in prostate cancer therapy: Clinical evidence and practical considerations.","authors":"Arthur Peyrottes, Michael Baboudjian, Eric Barret, Laurent Brureau, Charles Dariane, Jonathan Olivier, Guillaume Ploussard, Paul Sargos, Stephane Supiot, Romain Mathieu","doi":"10.1016/j.fjurol.2025.102934","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102934","url":null,"abstract":"<p><strong>Introduction: </strong>Androgen deprivation therapy (ADT) remains a cornerstone of treatment for both localized and metastatic prostate cancer (PC). Relugolix, an oral gonadotrophin-releasing hormone antagonist, provides a new option for achieving rapid testosterone suppression using an oral formulation.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted in PubMed by combining the search terms \"relugolix\", \"TAK-385\", \"MVT-601\", \"prostate cancer\", and \"prostatic neoplasms\" and focusing on prospective and retrospective studies published in English.</p><p><strong>Results: </strong>The HERO pivotal phase III trial demonstrated sustained testosterone suppression in 96.7% of patients with PC treated with relugolix versus 88.8% with leuprolide through to 48 weeks (P < 0.001). Relugolix achieved faster testosterone suppression and recovery post-treatment and a 54% lower risk of major adverse cardiovascular events compared with leuprolide. Data from HERO and phase II studies also support its use in combination with radiotherapy or other systemic therapies. Real-world studies performed to date have confirmed the effectiveness of relugolix, with more than 98% patients achieving castrate testosterone levels. Adherence to relugolix was generally high, and its safety profile aligned with clinical trial data. Practical considerations include, among others, treatment combination and drug-drug interactions, patient choice, and oncological outcomes.</p><p><strong>Conclusions: </strong>Clinical trials and real-world evidence support relugolix as a convenient and effective ADT option for PC. It offers rapid and sustained testosterone suppression, potential cardiovascular benefits, and an alternative to injectable therapies. Long-term adherence, the use of combination treatments and related drug-drug interactions require further investigation.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102934"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719315","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":"Concomitant anti-incontinence procedure at the time of prolapse repair - Never.","authors":"Alicia Blondeau, Brigitte Fatton, Renaud Detayrac","doi":"10.1016/j.fjurol.2025.102927","DOIUrl":"https://doi.org/10.1016/j.fjurol.2025.102927","url":null,"abstract":"","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"102927"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719342","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}