The French journal of urology最新文献

{"title":"Beyond GnRH analogues: The renaissance of estrogens in prostate cancer management.","authors":"Madalina Matthys, Clément Klein, Thierry Roumeguère, Franck Bladou, Grégoire Robert, Bertrand Tombal","doi":"10.1016/j.fjurol.2026.103139","DOIUrl":"10.1016/j.fjurol.2026.103139","url":null,"abstract":"<p><strong>Context: </strong>Androgen deprivation therapy (ADT) induced by LHRH agonists or antagonists for the treatment of advanced prostate cancer induces a concomitant suppression of estradiol levels. This estrogen deficiency is responsible for significant side effects that impair patients' quality of life (QoL). The role of estrogens in prostate cancer management is currently being investigated in multiple clinical trials, either as a replacement for conventional ADT or as add-back therapy combined with standard ADT.</p><p><strong>Methods: </strong>A literature search was conducted on PubMed using the following keywords: androgen deprivation therapy (ADT), bone loss, estrogen deficiency symptoms, hot flushes, and transdermal estradiol (tE2), for articles published between 1970 and 2026.</p><p><strong>Results: </strong>Estrogen suppression is responsible for multiple adverse effects, including loss of bone mineral density (BMD), vasomotor symptoms, metabolic disorders, and fatigue. However, the use of tE2 remains associated with a notably higher incidence of gynecomastia compared with conventional ADT.</p><p><strong>Conclusions: </strong>The suppression of estrogens by ADT induces multiple deleterious effects justifying the re-evaluation of controlled estrogen replacement. Available data regarding the use of transdermal estradiol or estetrol (E4) as add-on therapy are preliminary but encouraging although larger randomized trials are needed to confirm their integration into routine clinical practice.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103139"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152921","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":"Prevalence of homologous recombination repair genes alterations in metastatic castration-resistant prostate cancer, a multicentric study.","authors":"Pierre Allaume, Maxime Raby, Maya Nourieh, Alexandra Lespagnol, Anne Tallet, Sarah Péricart, Juliet Tantot, Véronique Lindner, Myriam Decaussin, Céline Callens, Françoise Descotes, Yves Allory, Nathalie Rioux-Leclercq, Solène-Florence Kammerer-Jacquet, Gaëlle Fromont","doi":"10.1016/j.fjurol.2026.103148","DOIUrl":"10.1016/j.fjurol.2026.103148","url":null,"abstract":"<p><strong>Introduction: </strong>Homologous Recombination Repair (HRR) genes alterations are a resistance mechanism to therapies by taxanes or Androgen Receptor Signalling inhibitors in Metastatic Castration Resistant Prostate Cancer (mCRPC). BRCA-mutated mCRPC patients are eligible to poly adenosine diphosphateribose polymerase inhibitors (PARPi). Therefore, assessing the population-specific prevalence of HRR-related genes alterations is of public healthcare importance.</p><p><strong>Methods: </strong>This retrospective, non-interventional, multicentric study was conducted across 6 reference French centers in a \"real-life\" setting. 788 paraffin-embedded mCRPC patient-samples were included and submitted to testing for BRCA1/2 in six different centers; additionally, non-BRCA HRR-related genes were investigated in two different centers.</p><p><strong>Results: </strong>Among the samples, n=602 (76.4%) were contributive for molecular testing. In multivariate analysis by logistic regression and sensitivity analysis, only sample age (P<0.01), sample surface area (P=0.02) and institution (P=0.018) remained statistically significant. BRCA alterations were detected in n=39/602 (6.5%) of contributive samples, with n=35 and n=4 alterations of BRCA2 and BRCA1 respectively. Non-BRCA HRR-related genes alterations were detected in n=12/157 (7.6%) of contributive samples, with alterations of mainly ATM (n=6, 3.8%), CDK12 (n=4, 2.5%) and CHEK2 (n=2, 1.3%).</p><p><strong>Discussion: </strong>In this study, testing contributivity was similar or higher that of other studies in the literature, and observed mutations prevalences were similar to that of other screenings of western populations. Harmonising per-centres protocols and enhancing molecular testing contributivity with the screening of circulating DNA samples and expanding its range by including non-BRCA HRR-related genes in all reference centres will enable more patients to be accurately treated by targeted therapies.</p><p><strong>Level of evidence: </strong>3 (grade C).</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103148"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267639","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":"Health status assessment and surgical decision-making for older adults in urology: Results from an International Survey of the EAU Young Academic Urology Group.","authors":"Patrick Juliebø-Jones, Arman Tstaturyan, Begoña Ballesta Martinez, Stephen Baug, Amelia Pietropaolo, Lazaros Tzelves, Rifat Burak Ergül, Stamatios Katsimperis, Angelis Peteinaris, Eugenio Ventimiglia, Christian Beisland, Bhaskar Somani","doi":"10.1016/j.fjurol.2026.103142","DOIUrl":"10.1016/j.fjurol.2026.103142","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults represent an increasing proportion of urological patients and often present with frailty, multimorbidity, and functional decline, complicating clinical decision-making. This study explored urologists' perspectives and practices in managing older and/or frail patients.</p><p><strong>Materials and methods: </strong>An international, anonymised, cross-sectional survey based on a modified SIOG questionnaire was distributed via the EAU Young Academic Urology network and social media (February 2026). Domains included demographics, geriatric assessment practices, decision-making factors, and training perspectives. Descriptive statistics were used.</p><p><strong>Results: </strong>A total of 102 urologists responded, predominantly consultants (71.6%) and based in Europe (89.2%). Routine geriatrician involvement was limited (15%), with 19.4% reporting no access. While most respondents were familiar with frailty concepts (74.5%), only 13.8% reported routine use of formal tools. Decision-making was driven primarily by comorbidity burden (78.5%), functional status (52.7%), anaesthetic assessment (50.5%), and frailty status (48.4%), whereas formal tools (5.4%) and chronological age (24.7%) were less influential. Anaesthetic opinion and anticipated recovery burden strongly influenced decisions. Most clinicians routinely discussed recovery and quality of life. Over 90% supported inclusion of frailty assessment in training.</p><p><strong>Conclusion: </strong>Frailty is recognised but underutilised in urological practice. Greater integration of simple assessment tools, geriatric expertise, and targeted training is needed to improve care for older patients.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103142"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214192","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":"Non-obstructive azoospermia: Micro-TESE combined with advanced sperm processing for enhanced assisted reproductive outcomes.","authors":"Pauline Venot, Benoît Mesnard, Aurélie Schirmann, Marine Poulain, Camelia Radulescu, Achraf Benammar, Jean-Marc Ayoubi, Thierry Lebret, Cyrille Guillot-Tantay, Vincent Izard, François-Xavier Madec","doi":"10.1016/j.fjurol.2026.103147","DOIUrl":"10.1016/j.fjurol.2026.103147","url":null,"abstract":"<p><strong>Introduction: </strong>Non-obstructive azoospermia (NOA), which accounts for 10% of male infertility cases, is managed by microdissection testicular sperm extraction (mTESE), currently consider the gold standard technique. While mTESE improves sperm retrieval rates (SRR) and minimizes testicular damage, this is only the first step in the assisted reproductive technology (ART) pathway, whose goal is live birth. Advanced sperm preparation techniques, including SpermVD® vitrification and synchronous oocyte retrieval, may further optimize outcomes. However, live birth and ongoing pregnancy rates (LBR) after mTESE remain poorly reported. This study aimed to evaluate reproductive outcomes following mTESE combined with advanced sperm preparation techniques in NOA.</p><p><strong>Materials & methods: </strong>This retrospective study included 55 patients with NOA who underwent mTESE between July 2019 and March 2023. The primary outcomes included LBR, while the secondary outcome concerned SRR. Univariate analyses were performed to identify risk factors associated with unsuccessful sperm retrieval.</p><p><strong>Results: </strong>Mean age was 36.6years, mean FSH level of 20.9IU/L and mean testicular volume was 7.4mL. SRR was 47.3% (95% CI: 34.2% - 60.4%) and increased to 53.2% after excluding Klinefelter patients. Live birth and ongoing pregnancies were achieved in 27.3% of couples (95% CI: 15.5% - 39.1%) and 57,7% of positive biopsies (95%. CI: 38,5% - 76,9%). Karyotype abnormalities (P=0.025), elevated FSH (P=0.029), and familial infertility (P=0.003) were associated with unsuccessful sperm retrieval.</p><p><strong>Conclusion: </strong>In our cohort, mTESE enabled 27.3% of couples to achieve a live birth or ongoing pregnancy without requiring sperm donation.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103147"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261261","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":"Factors associated with pessary discontinuation in women with pelvic organ prolapse: A retrospective observational study.","authors":"Joris Poquet, Clémence Faure, Aude Szpytma, Claire Cardaillac, Ylan Camby, Thibault Thubert","doi":"10.1016/j.fjurol.2026.103168","DOIUrl":"10.1016/j.fjurol.2026.103168","url":null,"abstract":"<p><strong>Introduction: </strong>Pessary therapy is an effective conservative option for pelvic organ prolapse management, yet discontinuation remains frequent. This study aimed to identify factors associated with pessary discontinuation among women with pelvic organ prolapse.</p><p><strong>Materials and methods: </strong>This retrospective observational study included women who attended a pessary fitting visit in two tertiary care centers between July 2022 and February 2025. Data were extracted from medical records and supplemented by a telephone survey. Pessary discontinuation was defined as non-use of the device at the time of the survey. Associations with pessary discontinuation were assessed using univariable and multivariable logistic regression models.</p><p><strong>Results: </strong>Among 152 women screened, 87 responded to the survey and were included in the analysis. At the time of the interview, 39 women had discontinued pessary use. In univariable analysis, discontinuation was associated with urinary-predominant baseline complaint, associated urinary symptoms, unmasked stress urinary incontinence after prolapse reduction, prior hysterectomy, discomfort during use, pessary expulsion, and vaginal pain. In multivariable analysis, prior hysterectomy (aOR=5.33; 95% CI, 1.31-28.16; P=0.028), associated urinary symptoms (aOR=2.87; 95% CI, 1.05-8.60; P=0.046), and unmasked stress urinary incontinence after prolapse reduction (aOR=10.07; 95% CI, 1.46-204.60; P=0.044) remained associated with discontinuation after adjustment.</p><p><strong>Conclusion: </strong>Pessary discontinuation was associated with prior hysterectomy, urinary symptoms, and unmasked SUI after prolapse reduction. Careful fitting, tailored counseling, and early reassessment may help optimize adherence.</p><p><strong>Level of evidence: </strong>Level 1.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564312","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":"Evaluation of a multisensory hypnosis mask during transrectal ultrasound-guided prostate biopsy: Results of a randomized controlled trial.","authors":"Brigitte Cortes, Hélène Béhal, Julien Labreuche, Isabelle Grit, Philippe Puech, Jonathan Olivier","doi":"10.1016/j.fjurol.2026.103167","DOIUrl":"10.1016/j.fjurol.2026.103167","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether the Hypnos Pro® mask - a multisensory hypnosis-based device combining light stimulation, auditory guidance, and hypnotic narration - reduces pain and anxiety during transrectal ultrasound-guided prostate biopsy (TRUS-Bx).</p><p><strong>Methods: </strong>This randomized controlled trial compared TRUS-Bx performed with or without the Hypnos Pro® mask. Initially designed to include 172 patients, the study was prematurely stopped after randomization of 99 participants due to changes in clinical practice (Hypnos Pro® group, n=49; control group, n=50). Pain intensity was assessed using a Visual Analogue Scale (VAS) 20minutes after probe removal. Anxiety was measured using the Spielberger State-Trait Anxiety Inventory (STAI-YA). Secondary outcomes included procedure characteristics, patient willingness to repeat the biopsy, and staff satisfaction.</p><p><strong>Results: </strong>Eighty-eight patients were analyzed (Hypnos Pro®: n=45; control: n=43). Median pain VAS scores were significantly higher in the Hypnos Pro® group than in controls (2.2 [1.2-4.8] vs. 1.4 [0.5-3.2]; P=0.038). After stratified analysis adjusting for prior biopsy history and education level, this difference did not reach statistical significance (P=0.10). Changes in STAI-YA scores did not differ significantly between groups (-5.1±9.0 vs. -6.6±8.8; P=0.56). Procedure duration and number of biopsy cores were comparable between groups. Willingness to repeat the procedure was similar (84% vs. 91%; P=0.40).</p><p><strong>Conclusion: </strong>The use of the Hypnos Pro® mask did not reduce pain or anxiety during TRUS-guided prostate biopsy. Pain scores were higher in the mask group in the unadjusted analysis, but this difference did not remain significant after adjustment for baseline imbalance. These findings do not support the routine use of multisensory hypnosis devices during prostate biopsy. Further studies are warranted to clarify the impact of sensory isolation devices on patient comfort during prostate biopsy.</p><p><strong>Level of evidence: </strong>level 3.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103167"},"PeriodicalIF":1.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564395","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":"Preventive posterior mesh placement during laparoscopic double sacrocolpopexy for anterior urogenital prolapse: Anatomical and functional outcomes from a 20-year single center experience.","authors":"Charles Maillard, Thibault Tricard, Hervé Lang, Christian Saussine","doi":"10.1016/j.fjurol.2026.103164","DOIUrl":"10.1016/j.fjurol.2026.103164","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Genital prolapse is a common and disabling functional condition in women, affecting nearly one-third of women over 70years of age in France. This descriptive study reviews the systematic use of laparoscopic double sacrocolpopexy (LDS) in our center, assessing its anatomical and functional benefits in the management of anterior or apical prolapse to prevent secondary rectocele.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This retrospective, descriptive, single-center French study included 41 patients who underwent LDS between 2000 and 2019, with at least 5years of follow-up. Patients were reassessed using a structured interview, self-administered questionnaires (MHU, PFIQ-7, I-QOL, UDI-6, USP) and a gynecological examination. The primary objective was the anatomical outcome of the posterior compartment after LDS with preventive pre-rectal mesh placement. Secondary objectives were the functional impact on overall and specific (urinary and digestive) quality of life, the anatomical outcomes of the anterior and middle compartments, and peri- and postoperative complications (Clavien-Dindo classification).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;With an average follow-up of 11.2years, the anatomical success rate (absence of rectocele stage≥2 according to Baden-Walker) reached 98% (40/41). At reassessment, 71% of the cohort (29/41) had no rectocele. Among the 12 patients with postoperative rectocele (29% with follow-up&gt;5years), the vast majority had BW stage 1 rectocele (11/12). Furthermore, none of these patients required reintervention for rectocele following LDS (12/12), and no posterior colporrhaphy was performed. Functionally, urinary and digestive disorders were uncommon, as reflected by promising quality-of-life scores: MHU (2.75/28), I-QOL (104/110), PFIQ-7 (11/300), UDI-6 (2.6/18) and USP (1.2/9; 1.8/21; 0.7/9). In the long-term (follow-up&gt;5years), 9% (4/41) had persistent anorectal discomfort, compared with 39% (16/41) in the early postoperative period (&lt;3 months), suggesting that persistent ano-rectal discomfort improves over time after surgery. Finally, no severe complications (Clavien-Dindo ≥3) were observed during follow-up. Regarding the anterior compartment, 65% (27/41) had grade 1 cystocele and 25% (10/41) had grade 2 according to Baden-Walker (BW). Overall, 85% reported satisfaction with the procedure, particularly regarding the correction of their initial urogenital prolapse and the resolution of pelvic heaviness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study shows that laparoscopic double sacrocolpopexy (LDS) achieves high anatomical success rates following preventive posterior mesh placement in patients with anterior urogenital prolapse. In our study population, this technique is associated with a very low incidence of rectocele and resulted in minimal long-term functional sequelae, with limited impact on both overall quality of life and urinary and digestive function. Nevertheless, the lack of a control g","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498662","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":"Guidelines from the cancer (CCAFU) and infection disease (CI-AFU) committees of the French Association of Urology for the management of adverse events and complications of BCG.","authors":"Priscilla Leon, Laura I Levi, Thibaut Long Depaquit, François Audenet, Yves Allory, Alexandra Masson-Lecomte, Benjamin Pradère, Thomas Seisen, Evanguelos Xylinas, Gautier Marcq, Thibault Constance, Anne Sophie Bajeot, Doriane Prost, Morgan Roupret, Yann Neuzillet, Maxime Vallée, Mathieu Roumiguié","doi":"10.1016/j.fjurol.2026.103105","DOIUrl":"10.1016/j.fjurol.2026.103105","url":null,"abstract":"<p><strong>Introduction: </strong>Intravesical instillations of BCG are recommended for the treatment of high-risk non-muscle invasive bladder cancer. However, their prolonged use remains limited by potentially serious adverse events (AEs) or complications. The aim of this article is to provide updated recommendations for the diagnosis and management of AEs or complications of intravesical BCG instillations.</p><p><strong>Materials: </strong>A review of the literature was performed using Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com), and the following MeSH keywords or a combination of keywords: \"Bladder\"; \"BCG\"; \"Complication\"; \"Toxicity\"; \"Adverse events\"; \"Prevention\"; \"Treatment\".</p><p><strong>Results: </strong>AEs or complications of BCG included genitourinary and systemic symptoms. The most common complications (cystitis, moderate fever) should be treated symptomatically and may require BCG adjustment to allow patients to have the most complete BCG course possible. Serious complications are rare but must be identified promptly because of their life-threatening nature. Their management is based on a combination of anti-tubercular treatment, anti-inflammatory drugs, and permanent discontinuation of BCG.</p><p><strong>Conclusion: </strong>The management of AEs during BCG therapy requires early identification, rational and effective treatment if necessary, and discussions about the continuation of BCG therapy in each situation.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103105"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719295","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":"Re: Transition to adulthood after childhood cystoplasty: Patient perspectives \"An urgent call for structured care pathways in the transition to adulthood\".","authors":"Charles Mazeaud, Alicia Blondeau","doi":"10.1016/j.fjurol.2026.103103","DOIUrl":"10.1016/j.fjurol.2026.103103","url":null,"abstract":"","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103103"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680018","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":"Preoperative urine culture in urology: Indications and management - The 2026 French guidelines.","authors":"Maxime Vallée, Stessy Kutchukian, Hugo Crespin, Nadia Abid, Matthieu Boisson, Patrick Coloby, Julien Derdevet, Aurélien Dinh, Diana Kassab, Olivia Keïta-Perse, Eric Kipnis, Matthieu Lafaurie, Marc Leone, Martine Pestel-Caron, Albert Sotto, Valentine Berti, Omar Karray, Franck Bruyère","doi":"10.1016/j.fjurol.2026.103126","DOIUrl":"10.1016/j.fjurol.2026.103126","url":null,"abstract":"<p><strong>Introduction: </strong>Before interventional or surgical procedures, urine culture (UC) is often carried out and probabilistic antibiotic therapy is often prescribed without any real justification. Reducing the inappropriate UC use will contribute to limit antibiotic consumption and antibiotic resistance. The aim of this work was to provide guidelines on: i) UC role in the diagnosis of asymptomatic bacteriuria before urological procedures in adults, depending on the procedure and patient risk factors; ii) how to perform the UC test; and iii) management of patients with positive UC.</p><p><strong>Methods: </strong>A systematic review of studies published between January 2000 and June 2025 was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The guidelines were developed by a multidisciplinary task force following the \"formalized consensus of experts\" method proposed by the national French Haute Autorité de Santé (two rounds of iterative quotations and reviewing by independent experts).</p><p><strong>Results: </strong>In total, 84/732 publications met the inclusion criteria. Preoperative UC is no longer recommended before radical prostatectomy, radical cystectomy, cystoscopy, intravesical instillations, artificial urinary sphincter implantation, and penile prosthesis implantation. Bacterial colonization treatment should be initiated 48h before surgery and may be discontinued on surgery day or continued for up to 48h post-surgery. First-line agents for the perioperative management of bacterial colonization of urine include fosfomycin trometamol, nitrofurantoin, pivmecillinam and trimethoprim.</p><p><strong>Conclusions: </strong>These guidelines describe the recommended UC indications for urological patients to personalize their management and avoid unnecessary urine cultures and antibiotic treatments.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103126"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825705","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}