The French journal of urology最新文献

{"title":"Impact of homologous recombination repair gene mutations on survival in metastatic prostate cancer: A real-world analysis from an observational database.","authors":"Géraldine Cancel-Tassin, Thilina Kariyawasam, Laurène Gautier, Lucile Lefèvre, Olivier Cussenot","doi":"10.1016/j.fjurol.2026.103143","DOIUrl":"10.1016/j.fjurol.2026.103143","url":null,"abstract":"<p><p>The prognostic significance of homologous recombination repair gene (HRRg) mutations across the different metastatic prostate cancer stages remains unclear. This retrospective real-world study analyzed 162 metastatic castration-sensitive (mCSPC) and 126 castration-resistant (mCRPC) patients from the ProGène database, stratified by HRRg mutational status. Mutation prevalence was similar in both groups (16.0% in mCSPC vs. 13.5% in mCRPC). HRR-positive mCSPC patients had significantly shorter median overall survival (OS) (24.0months; 95% confidence interval [CI]: 16.0-41.0) compared to HRR-negative patients (45.0months; 95% CI: 34.0-69.0; P=0.04). Notably, BRCA2-mutated patients exhibited a reduced median OS of 24.0months (95% CI: 9.0-40.0; P=0.036) and a faster progression-free survival compared to HRR-negative patients (median PFS=8.0months; 95% CI: 0.0-14.0 vs. 17.0months; 95% CI: 12.0-20.0; P=0.006). These findings suggest that HRRg mutations - especially BRCA2 - are associated with worse prognosis in mCSPC, supporting the value of early genomic screening to guide personalized treatment strategies.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103143"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214156","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":"Achieving no evidence of disease in metastatic renal cell carcinoma: Consolidative nephrectomy vs ablative therapy.","authors":"Augustin Zelmar, Victor Gaillard, Roberto-Luigi Cazzato, Thibault Tricard, Philippe Barthelemy, Fabien Moinard-Butot, Afshin Gangi, Hervé Lang","doi":"10.1016/j.fjurol.2026.103132","DOIUrl":"10.1016/j.fjurol.2026.103132","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic therapies (ST¹) have improved outcomes in metastatic renal cell carcinoma (mRCC²) but have a limited effect on the primary renal tumor. As deeper responses improve survival, consolidative treatment (CT³) to achieve \"No Evidence of Disease\" is increasingly considered. While surgery remains the standard, renal cryoablation (CA⁴), a less invasive option, is gaining interest.</p><p><strong>Material and methods: </strong>We conducted a retrospective single-center study (2010-2025) of synchronous mRCC patients undergoing CT after achieving a complete metastatic response with ICI±TKI. Evaluated modalities included partial nephrectomy (PN⁵), radical nephrectomy (RN⁶), and CA. The primary objective was the oncological efficacy of each modality, measured by the 1-year recurrence rate. Secondary objectives included overall recurrence-free survival (RFS⁷) and morbidity.</p><p><strong>Results: </strong>Twenty-one patients underwent CT: 10 PN, 7 RN, and 4 CA. Median age was 65 years. Seventeen patients (81%) received ICI±TKI, and four (19%) received TKI alone. Median preoperative tumor sizes were 43.5, 68, and 25mm in the PN, RN, and CA groups, respectively (P=0.01). Median follow-up was 31 (23.5-73.5) months. The 1-year recurrence rates were comparable: 22.2% (PN), 16.7% (RN), and 25% (CA) (P=0.61). ST was discontinued postoperatively in 84% (16/19) of patients. Although not statistically significant, CA showed a trend toward lower morbidity than consolidative nephrectomy (CN⁸), with better preservation of renal function, less blood loss, and shorter hospital stays.</p><p><strong>Conclusion: </strong>Consolidative renal CA, with its reduced morbidity, could be a viable alternative for frail patients unfit for CN, warranting validation in larger prospective studies. LEVEL OF EVIDENCE (HAS): 4 (descriptive studies).</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103132"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990658","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":"Vacuum erection devices in the management erectile dysfunction: A systematic review.","authors":"Cyrille Guillot-Tantay, Antoine Faix, Diana Kassab, Cédric Lebacle, Jean-Pierre Graziana, Eric Huyghe","doi":"10.1016/j.fjurol.2026.103134","DOIUrl":"10.1016/j.fjurol.2026.103134","url":null,"abstract":"<p><p>Erectile dysfunction (ED) is a prevalent male sexual disorder associated with aging and comorbidities. Vacuum erection device(s) represent a non-invasive therapeutic option that can be proposed to patients with ED, either as monotherapy or in combination with pharmacological or psychosexual therapies. This systematic review summarizes the current evidence on vacuum erection device(s) in ED management based on a focused literature review which allowed the AFU/SFMS 2024 guidelines elaboration. Evidence shows that vacuum erection device(s) improve penile length in surgical candidates, enhance outcomes in combination with phosphodiesterase type 5 inhibitors, and may support psychosexual interventions. Their safety profile is favorable, although long-term adherence remains variable. Vacuum erection device(s) should be systematically considered as part of a personalized treatment strategy for ED after considering first intention treatment as PDE5 inhibitors or local drug treatment.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103134"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102361","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":"Stress urinary incontinence in French elite athletes from different disciplines: A cross-sectional study.","authors":"Pauline Eon, Vincent Fontanier, Maëlle Lacroix, Caroline Ferrer-Lormeau, Arnaud Bruchard, David Laplaud, Jean-Philippe Hager","doi":"10.1016/j.fjurol.2026.103131","DOIUrl":"10.1016/j.fjurol.2026.103131","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Stress urinary incontinence (SUI) affects 66% of elite female athletes across various sports. The aim of this study was to establish the prevalence of SUI and identify associated factors among high-level female athletes in different athletics disciplines in France.</p><p><strong>Methods: </strong>Sixty-five elite female athletes in athletics (mean age: 23.3±7.4 years) completed a questionnaire specifically designed to assess SUI prevalence and its associated factors.</p><p><strong>Results: </strong>The overall prevalence of SUI was 58% across all disciplines in athletics. No significant associations were observed between SUI prevalence and any of the factors examined, including athletics discipline, type of effort, weekly training hours, daytime and nighttime urinary frequency, urgency, number of pregnancies, menstrual cycle regularity, medical history, age, or years of high-level practice (all P>0.3).</p><p><strong>Conclusion: </strong>SUI affects more than one in two high-level female athletes in athletics in France. Although numerous factors are potentially associated with SUI, our findings did not reveal a significant relationship between SUI prevalence and the factors evaluated in this study. Future research should focus on the impact of menstrual cycle variations and neuromuscular control of the pelvic floor muscles on SUI prevalence.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103131"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990721","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":"Phytotherapies and complementary therapies for erectile dysfunction: A focused secondary synthesis and critical clinical interpretation of the AFU/SFMS evidence base.","authors":"Cédric Lebâcle, Diana Kassab, Antoine Faix, Cyrille Guillot-Tantay, Johann Barkatz, Eric Huyghe","doi":"10.1016/j.fjurol.2026.103138","DOIUrl":"10.1016/j.fjurol.2026.103138","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a focused secondary synthesis and critical clinical interpretation of the AFU/SFMS evidence base on phytotherapies and complementary therapies for erectile dysfunction (ED).</p><p><strong>Evidence acquisition: </strong>The parent AFU/SFMS evidence review used a predefined systematic search and selection process in PubMed/Medline for French- and English-language publications from January 1999 to January 2023, updated to October 2023. Eligible evidence comprised systematic reviews, meta-analyses, randomized trials, and prospective non-randomized studies in adult men with ED. Outcomes included IIEF/IIEF-5, EHS, satisfaction, adverse events, and physiologic measures. No de novo search or risk-of-bias reassessment was performed for this secondary manuscript.</p><p><strong>Results: </strong>The evidence base was broad but fragmented. The most coherent phytotherapy signal concerned traditional Chinese herbal medicine combined with tadalafil, with a pooled IIEF-5 weighted mean difference of 3.11 points, although comparator structure and non-standardized formulations limit interpretation. Ginseng, L-arginine, and Pycnogenol showed modest low-certainty signals. Other agents and proprietary formulations remained preliminary or inconsistent. Among complementary therapies, pelvic floor muscle training provided the clearest actionable signal; in the pivotal trial, 40% of men regained normal erectile function by 6 months. Acupuncture and electrical or magnetic therapies were hypothesis-generating. Cognitive behavioral therapy appeared clinically discussable as an adjunct.</p><p><strong>Conclusion: </strong>Evidence does not support routine recommendation of phytotherapies or most complementary therapies for ED. A few coherent but low-certainty signals may inform counseling, but claims remain weakened by heterogeneity, short follow-up, and bias. These interventions should guide shared decision-making and research priorities, not replace validated ED care.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103138"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152945","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":"Primary Ewing sarcoma of the penis in an adult man: First reported case in France.","authors":"Coline Ricolleau, Mikael Abi Abdallah, Elias Ayoub, Caroline Plazanet, Mathilde Vionnet, Nicolas Isambert, Stessy Kutchukian","doi":"10.1016/j.fjurol.2026.103136","DOIUrl":"10.1016/j.fjurol.2026.103136","url":null,"abstract":"<p><p>Extra-skeletal Ewing sarcoma (EES) is an extremely rare condition, with only 10 cases reported worldwide. The challenge in this case remains the diagnosis, which relies on immunohistochemical and molecular testing: small round blue cells, CD99-positive expression and the presence of an EWSR1/FLI1 gene fusion. We herein report a 43-year-old male with a primary penile Ewing sarcoma, without apparent symptoms, and whose tumor type was difficult to identify on biopsy, with no definite histological diagnosis established before final surgery. A partial penectomy and adjuvant chemotherapy with vincristine, doxorubicin, and cyclophosphamide alternating once every 2 weeks with ifosphamide and etoposide were performed, with no recurrence at one year. This case highlights the importance of initial management of tumors of undetermined type, where complete surgical treatment is key to improving disease-free survival (DFS). To our knowledge, this is the first reported case in France.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103136"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102364","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":"Editorial on evaluating functional outcomes of urethroplasty for complete post-traumatic rupture of the posterior urethra.","authors":"Paul Neuville, Ismael Chelghaf","doi":"10.1016/j.fjurol.2026.103141","DOIUrl":"10.1016/j.fjurol.2026.103141","url":null,"abstract":"","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103141"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214108","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":"Day-case HOLEP: How to optimize outcomes? Insights from 10 years of clinical experience.","authors":"Xavier Lacroix, Clément Klein, Gaelle Margue, Grégoire Capon, Eric Alezra, Peggy Blanc, Vincent Estrade, Franck Bladou, Jean-Christophe Bernhard, Grégoire Robert","doi":"10.1016/j.fjurol.2026.103129","DOIUrl":"10.1016/j.fjurol.2026.103129","url":null,"abstract":"<p><strong>Introduction: </strong>Most international guidelines recommend HoLEP for the surgical management of BPH. The main advantages reported by randomized studies are reduced perioperative bleeding, catheterization time, and length of hospitalization. To optimize patient care and address healthcare costs, day-case HoLEP has been developed, with our team among the first to implement this approach in 2012. This study aimed to evaluate the evolution of our outcomes over time and to identify predictive factors for day-case failure.</p><p><strong>Materials and methods: </strong>Clinical data on HoLEP procedures were prospectively collected. We retrospectively analyzed perioperative data from consecutive day-case procedures performed at our institution between January 2013 and April 2024 by a single expert surgeon (n=721). Day-case success was defined as discharge within 12hours of admission without readmission within 48hours. The cohort was divided into three chronological groups of 240 patients each to assess the evolution of outcomes over time. Uni- and multivariate analyses were performed to identify predictive factors of failure.</p><p><strong>Results: </strong>Overall, 86.6% of patients (n=625) were discharged within 12hours, and 84.1% (n=606) were not readmitted within 48hours. The main cause of discharge failure was hematuria requiring bladder irrigation. Day-case failure rates remained stable across the three chronological groups. In univariate analysis, prostate volume (P=0.03) and prostate volume >90g (P=0.01) were associated with discharge failure. In multivariate analysis, prostate volume >90g remained the only independent predictor (OR=1.9, P=0.015).</p><p><strong>Conclusion: </strong>Day-case HoLEP is a safe and feasible option that does not increase patient risk and should be considered in routine practice. Prostate volume >90g is the only significant predictor of failure, while other patient-related factors have no impact.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103129"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825549","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":"Is perirenal fat an active player in renal cell carcinoma tumorigenesis? A radiologic-pathologic correlation study.","authors":"Yusuf Gökkurt, Tolga Karakan, Buğra Bilge Keseroğlu, Veysel Bayburtluoğlu, Demirhan Örsan Demir, Ali Kaan Yıldız, Turgay Kaçan","doi":"10.1016/j.fjurol.2026.103133","DOIUrl":"10.1016/j.fjurol.2026.103133","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a significant modifiable risk factor for renal cell carcinoma, yet its involvement in tumor development pathways remains incompletely understood. Perirenal fat tissue has been implicated in various metabolic and oncologic processes. The Mayo Adhesive Probability score is widely used for quantitative and qualitative assessment of perirenal fat tissue. This study aimed to investigate the relationship between perirenal fat tissue evaluated by the Mayo Adhesive Probability score and tumor pathology in patients with renal cell carcinoma.</p><p><strong>Material: </strong>Patients who underwent surgery for a renal mass between January 2014 and July 2022 with pathology confirming clear cell renal cell carcinoma were included. Retrospective analysis of patient data, pathology findings, and radiological measurements of perirenal fat tissue was performed. Patients with prior surgical interventions potentially affecting perirenal fat evaluation were excluded.</p><p><strong>Results: </strong>Data from 156 patients were analyzed. A statistically significant positive correlation was observed between posterior perirenal fat thickness and nuclear grade (r=0.186, P=0.022). The Mayo Adhesive Probability score was also positively associated with nuclear grade (r=0.290, P<0.001) and T stage (r=0.272, P<0.001).</p><p><strong>Conclusion: </strong>To our knowledge, this study is the first to demonstrate a relationship between perirenal fat thickness and nuclear grade, as well as the Mayo Adhesive Probability score and nuclear grade, based on the current grading system. These findings suggest that perirenal fat tissue may contribute to tumorigenesis in clear cell renal cell carcinoma. Further prospective studies are needed to validate and build upon these findings.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103133"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990698","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":"Long-term satisfaction and outcomes after inflatable penile prosthesis implantation: A single-center study using the SSIPI Questionnaire.","authors":"Pauline Neuranter, Jeanne Beirnaert, Morgan Roupret, Ugo Pinar","doi":"10.1016/j.fjurol.2026.103153","DOIUrl":"10.1016/j.fjurol.2026.103153","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) significantly impacts quality of life. While inflatable penile prosthesis (PP) implantation is the gold standard for treatment-refractory cases, assessing long-term patient satisfaction remains a challenge due to the subjective nature of outcomes. This study aimed to evaluate long-term satisfaction following IPP implantation using the validated French version of the Satisfaction Survey for Inflatable Penile Implant (SSIPI), while assessing perioperative outcomes and long-term device survival.</p><p><strong>Patients and methods: </strong>This retrospective single-center study included all consecutive patients who underwent IPP implantation during 10years. Patient satisfaction was assessed via telephone interviews using the SSIPI questionnaire. Revision-free and removal-free survival were analyzed. Complications were classified according to the EAU Intraoperative Adverse Incident and Clavien-Dindo classifications.</p><p><strong>Results: </strong>A total of 201 patients were included (median age 63.3years). Among them, 89 (44.3%) completed the SSIPI questionnaire. The median SSIPI score was 67 [59-73], with 88.7% of patients classified as satisfied and 58.4% as highly satisfied. No significant predictors of satisfaction were identified. The overall postoperative complication rate was 16.9%, with 3% requiring surgical revision within 30days. During follow-up, 30.3% of patients underwent surgical revision, including 10.9% device removal. Revision-free survival at 60months was 61.7%, and device survival without removal was 83.6%. A history of prior PP implantation was the only significant risk factor for revision and removal.</p><p><strong>Conclusion: </strong>IPP implantation provides high patient satisfaction. Outcomes are multifactorial and cannot be explained solely by surgical success. Identifying predictors of dissatisfaction is essential to optimize long-term patient management.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103153"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335487","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}