The French journal of urology最新文献

{"title":"Comment on: Shams El-Din El-Behiri et al., Hypofractionated versus conventional IMRT in unfavorable intermediate- and high-risk prostate cancer: A phase II comparative study of PSA kinetics, dosimetric and toxicity outcomes, The French Journal of Urology, 2026.","authors":"Jennifer Le Guevelou, Gaelle Fiard, Michael Baboudjian","doi":"10.1016/j.fjurol.2026.103124","DOIUrl":"10.1016/j.fjurol.2026.103124","url":null,"abstract":"","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103124"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794294","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":"Evaluating functional outcomes of urethroplasty for complete post-traumatic rupture of the posterior urethra.","authors":"Kays Chaker, Ahmed Chaabouni, Boutheina Mosbahi, Yasmine Laabidi, Khouloud Ouertani, Ali Chakroun, Cheikh Abdallah, Wassim Ben Chedly, Yassine Ouanes, Mokhtar Bibi, Mahdi Marrak, Adel Ammous, Mourad Hadj Slimene, Yassine Nouira","doi":"10.1016/j.fjurol.2026.103127","DOIUrl":"10.1016/j.fjurol.2026.103127","url":null,"abstract":"<p><strong>Introduction: </strong>Post-traumatic posterior urethral rupture is a severe injury that may significantly affect the urinary and sexual outcome in predominantly young patients. Delayed urethroplasty after suprapubic catheterization remains a preferred approach and part of the urologist's therapeutic arsenal. The objective of our study was to report the urinary and sexual outcomes after delayed urethroplasty for complete post-traumatic rupture of the posterior urethra.</p><p><strong>Patients and methods: </strong>This is a retrospective multicentric study including all patients who underwent urethroplasty between 2014 and 2024 for complete post-traumatic rupture of the posterior urethra. Preoperative, perioperative, and postoperative outcome data were collected. Complications for the surgical procedure were analyzed, as well as postoperative stenosis, urinary incontinence and erectile dysfunction.</p><p><strong>Results: </strong>Forty-two patients were identified. The mean age was 33±10 years. In these patients, the mean postoperative bladder catheterization time was 20±4 days. The median postoperative follow- up period of 42 [24-64] months. Satisfactory voiding was noted in 28 patients (67%). The median IPSS score at the date of last news was 6 [0-22]. Internal urethrotomy following surgery was performed in night patients (22%), while three patients (7%) were treated for stress urinary incontinence. Five patients (12%) required a secondary urethroplasty. The median IIEF-5 score at the date of last news was 16 [15-19].</p><p><strong>Conclusion: </strong>We therefore consider urethroplasty as the treatment of choice for complete traumatic posterior urethral rupture. However, there is a high rate of severe erectile dysfunction after urethroplasty urethroplasty for complete post-traumatic rupture of the posterior urethra.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103127"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825581","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":"Real-life PI-RADS score and biochemical recurrence after local treatment of prostate cancer in Afro-Caribbean men.","authors":"Yvanne Sadreux, Kevin Kaulanjan, Melanie Laguerre, Philippe Mollard, Gilles Gourtaud, Cedric Senechal, Pascal Blanchet, Laurent Brureau","doi":"10.1016/j.fjurol.2026.103125","DOIUrl":"10.1016/j.fjurol.2026.103125","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic accuracy of prostate cancer has been improved by the use of multiparametric magnetic resonance imaging (MRI). However, the role of the Prostate Imaging-Reporting and Data System (PI-RADS) score in combination with MRI in predicting issues after local prostate cancer treatment remains unclear. The aim of this study was to evaluate the PI-RADS score as a predictive factor for biochemical recurrence or progression (BCR) of prostate cancer.</p><p><strong>Methods: </strong>This retrospective monocentric study included 304 men who underwent targeted prostate biopsies plus standard biopsies after MRI between 2017 and 2020. All the included patients had a PI-RADS score of at least 3. Survival probabilities were estimated by the Kaplan-Meier method. The hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between individual characteristics and BCR or progression were estimated using the Cox proportional hazards regression model for univariate and multivariate analyses. All tests were two-sided, and P<0.05 was considered to indicate statistical significance. All analyses were performed using StatView software version 5.0 and MedCalc software version 17.5.</p><p><strong>Results: </strong>In total, 283 patients were included in our study. The median age at biopsy was 67.8 years, and the median follow-up was 4.9 years. The median time to BCR or progression after active surveillance (AS) was 4.7 years. A total of 22.3% of the patients experienced biochemical recurrence. No risk factors for biochemical recurrence according to the MRI PI-RADS score were significantly identified by univariate or multivariate analyses. Biochemical-free survival was 87% for the PI-RADS 5 group, 90% for the PI-RADS 4 and 80% for the PI-RADS 3 group at 3 years. There were no significant differences among these three groups in terms of BCR-free survival (P=0.4).</p><p><strong>Conclusion: </strong>In the present study, MRI lesion description with PI-RADS or the usual risk group did not seem to be sufficient to predict biochemical recurrence after local prostate cancer treatment, especially in our particular population. Future studies could pair the PI-RADS with histologic data of the prostatic index lesion to predict recurrence.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103125"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794288","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":"Metabolic evaluation and management of patients with urolithiasis by urologists: International survey-based overview of current practice.","authors":"Luigi Candela, Aideen Madden, Letizia Maria Ippolita Jannello, Alejandra Bravo-Balado, Stefano Moretto, Marie Chicaud, Carlos Altez Fernandez, Federico Zorzi, Alberto Quara, Stessy Kutchukian, Marielou Letouche, Jorge Peña Lueza, Razvan-Ionut Popescu, Olivier Traxer","doi":"10.1016/j.fjurol.2026.103130","DOIUrl":"10.1016/j.fjurol.2026.103130","url":null,"abstract":"<p><strong>Introduction: </strong>Appropriate metabolic evaluation and subsequent management is a keystone of urolithiasis treatment and stone recurrence risk reduction. The EAU guidelines currently recommend full metabolic evaluation in high-risk stone formers. However, practices in terms of metabolic evaluation and metabolic management vary widely globally, thus raising the risk of stone recurrence. To assess current practice among urologists in terms of metabolic analysis and management following surgery for stone disease in different countries.</p><p><strong>Methods: </strong>A Google Forms survey including 14 closed questions was circulated to urologists and residents worldwide via research group networks. Information was collected regarding baseline demographics as well as current practices in metabolic evaluation. Descriptive statistics were used to describe respondents' characteristics.</p><p><strong>Results: </strong>Overall, a total of 253 respondents participated worldwide, with 81% from Europe. In total, 56% were aged 30-39 years old and 37% declared a subspecialty interest in Endourology. Overall, 12% of the surveyed urologists never request a metabolic evaluation for their patients after surgery, whereas 51% reserve full metabolic evaluation only for high-risk stone formers, and 37% perform full metabolic analysis for each patient after surgery. Two respondents out of 3 routinely and autonomously interpret results, and 37% personally manage any metabolic abnormalities. The vast majority of respondents (89%) personally recommend general preventive measures to avoid stone recurrences, and 64% would routinely prescribe alkalinization treatment when indicated.</p><p><strong>Conclusion: </strong>Despite the majority of respondents organizing full metabolic evaluation for their patients, only two out of three urologists are able to interpret results, and only one out of three personally manages any abnormalities detected. Moreover, a non-negligible percentage of urologists do not ask for metabolic evaluation at all. These results underscore the need for multidisciplinary management of patients with urolithiasis with nephrologist input, particularly in cases where a urologist may not have the necessary subspecialty expertise to manage complex metabolic stone disease.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103130"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857986","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":"Hypofractionated versus conventional IMRT in unfavorable intermediate- and high-risk prostate cancer: A phase II comparative study of PSA kinetics, dosimetric and toxicity outcomes.","authors":"Nada Samir Shams El-Din El-Behiri, Mohamed A Alm El-Din, Asmaa Mohamed Alkady, Rabab Mahmoud Moussa, Mohamed Mohamed Elshebeny","doi":"10.1016/j.fjurol.2026.103104","DOIUrl":"10.1016/j.fjurol.2026.103104","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is a leading global malignancy, with unfavorable intermediate-risk (UIR) and high-risk (HR) disease requiring optimized treatment strategies. Hypofractionated intensity-modulated radiotherapy (HF IMRT) has gained attention due to the low α/β ratio of prostate cancer, suggesting enhanced sensitivity to larger fraction sizes. This study compares PSA kinetics, dosimetric and toxicity outcomes between HF IMRT and conventional fractionated IMRT (CF IMRT).</p><p><strong>Methods: </strong>In this prospective phase II study, 60 patients with UIR or HR localized PCa were enrolled. Thirty patients received HF IMRT (60Gy in 20 fractions over 4 weeks) while 30 underwent CF IMRT (74-80Gy in 37-40 fractions over 7.4-8 weeks). All patients received androgen deprivation therapy. PSA levels were monitored regularly, and biochemical relapse-free survival (BRFS) was defined by the Phoenix criterion. Dosimetric parameters for bladder, rectum, femoral heads, bowel, and penile bulb were analyzed.</p><p><strong>Results: </strong>After a median follow-up of 17 months, 2.5-year BRFS was 96.7% in the HF IMRT group versus 90% in the CF IMRT group (P=0.612). PSA nadir values were comparable, but time to nadir was significantly shorter with HF IMRT (12.8 vs. 17.1 months, P=0.019), indicating a more rapid biochemical response. Dosimetric analysis revealed significantly lower bladder and rectal dose-volume exposures (P<0.001) and reduced femoral head maximum dose with HF IMRT. Target coverage metrics (D95, CI, HI) were similar between groups, confirming oncologic equivalence.</p><p><strong>Conclusion: </strong>Hypofractionated IMRT demonstrates durable PSA control with greater treatment efficiency and improved dosimetric safety compared to CF IMRT. As a phase II study, these findings are preliminary and subject to inherent limitations; therefore, definitive conclusions cannot be drawn. Nonetheless, they provide a strong rationale for appropriately designed phase III trials to validate the benefits of hypofractionation in unfavorable intermediate- and high-risk prostate cancer.</p><p><strong>Level of evidence: </strong>Evidence from multiple phase III randomized controlled trials and meta-analyses (Level 1) supports the non-inferiority of HF IMRT compared to CF IMRT, confirming equivalent biochemical control and toxicity outcomes.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103104"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679960","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":"A single-centre assessment of short-term functional outcomes of holmium laser enucleation vs. robot-assisted simple prostatectomy for medium and large-volume benign prostatic hyperplasia.","authors":"Alexandre Gac, Maxime Pattou, Jérémie Gallon, François Meyer, Arthur Peyrottes, Annabelle Goujon, Sonia Bebane, François Gaudez, Romain Clery, Emilien Seizilles de Mazancourt, Paul Meria, Pierre Mongiat-Artus, François Desgrandchamps, Alexandra Masson-Lecomte","doi":"10.1016/j.fjurol.2026.103101","DOIUrl":"10.1016/j.fjurol.2026.103101","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of the study was to compare short-term functional outcomes and quality of life (QoL) between robot-assisted simple prostatectomy (RASP) and holmium laser enucleation of the prostate (HoLEP) in patients undergoing surgery for medium and large-volume benign prostatic hyperplasia (BPH) in our centre.</p><p><strong>Material: </strong>In this retrospective study based on a prospectively maintained database, we included all consecutive patients treated with RASP or HoLEP at our centre between September 2021 and November 2023. Standardized questionnaires were administered preoperatively and at 6 and 20weeks postoperatively: IPSS with QoL item, Urinary Symptom Profile (USP) which includes stress urinary incontinence (SUI), overactive bladder (OAB) and dysuria assessment, as well as IIEF-5 score.</p><p><strong>Results: </strong>Among 161 patients who underwent surgery (144 HoLEP, 17 RASP), only 71 (44%) completed all questionnaires (56 HoLEP, 15 RASP). This study focuses on these 71 patients. Except for prostate volume, which was higher in the RASP group (159mL vs 85.5mL, P<0.01), baseline characteristics and functional scores were comparable. At 20weeks, median IPSS scores were similar (5 vs 2, P=0.57), but median QoL scores favoured RASP (0 vs 1, P=0.04). RASP was associated with lower stress incontinence at both 6 and 20weeks (USP SUI scores 4 vs 0, P=0.01 and 2 vs 0, P=0.01, respectively), and less overactive bladder at 6weeks (USP OAB at 6weeks 10 vs 7, P=0.04). Postoperative IIEF-5 scores and maximal urinary flow rates were not significantly different between groups.</p><p><strong>Conclusions: </strong>Despite significant methodological limitations (selection and attrition biases, small sample size, and severe imbalance between groups), RASP may be associated with better early outcomes, particularly regarding continence and overactive bladder symptoms. These findings are limited by a questionnaire completion rate of 44% and a 20-week follow-up.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103101"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597450","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":"Feasability and effectiveness of pelvic floor telerehabilitation: A retrospective pilot study.","authors":"Véronique Blanchard, Cléo Marmin, Anne-Cécile Pizzoferrato","doi":"10.1016/j.fjurol.2026.103072","DOIUrl":"10.1016/j.fjurol.2026.103072","url":null,"abstract":"<p><strong>Introduction: </strong>First-line treatment for urinary incontinence (UI) is pelvic floor rehabilitation. Our objective was to assess the feasibility and effectiveness of pelvic floor telerehabilitation on women's urinary symptoms.</p><p><strong>Material and methods: </strong>This was a retrospective pilot study evaluating the impact of a pelvic floor telerehabilitation program on the symptoms of 48 patients referred for UI between 2022 and 2024. The patients completed questionnaires at the beginning and end of the telerehabilitation program. The questionnaires included the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Urinary Symptom Profile (USP), Pelvic Floor Distress Inventory (PFDI-20), CONTILIFE, Wexner, and Kess. At the end of the program, the PGI-I (Patient Global Impression and Improvement) and a satisfaction questionnaire were also administered.</p><p><strong>Results: </strong>The mean age of the women was 52.5 years. They had received an average of 9.3 telerehabilitation sessions. The ICIQ-SF and CONTILIFE scores significantly improved after the program (13.1 vs. 5.8, P<0.005; 75.3 vs. 46.4, P<0.005, respectively), as did the USP, PFDI-20, Wexner, and Kess questionnaire scores (P<0.05). After the program, 83.4% of the patients reported feeling better/much better according to the PGI-I. All reported they would undergo the protocol again and would recommend it.</p><p><strong>Conclusion: </strong>Pelvic floor telerehabilitation can significantly improve urinary and perineal symptoms as well as the quality of life of patients with UI. If these results are confirmed in larger prospectives studies, pelvic floor telerehabilitation programs could be integrated into an expanded care package, particularly in geographical areas lacking specialized professionals.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103072"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947090","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":"Impact of new decrees on pelvic implant surgery in France: Results of a national survey among urologists and gynecologists.","authors":"Francois Meyer, Caroline Thuillier, Thibault Thubert, Sophie Hurel, Julia Klap, Caroline Brandon, Sandrine Campagne-Loiseau, Pierre-Olivier Bosset, Laurence Donon, Lucie Even, Marie Florin, Frederic Girard, Rebecca Haddad, François Hervé, Claire Richard, Adrien Vidart, Caroline Plassais, Jean-Nicolas Cornu, Benoit Peyronnet","doi":"10.1016/j.fjurol.2026.103073","DOIUrl":"10.1016/j.fjurol.2026.103073","url":null,"abstract":"<p><strong>Introduction: </strong>Recent decrees conditioning the placement of pelvic implants on a minimum annual activity threshold per institution have raised concerns. A survey was conducted among French urologists and gynecologists to assess their practices and perceptions of these measures.</p><p><strong>Methods: </strong>An online questionnaire was distributed via three scientific societies (AFU, CNGOF, SCGP) in May 2025. It covered four themes: respondents' characteristics, experience in pelviperineology, impact of the new decrees, and opinions on surgical thresholds. The response collection period was 21days, with a reminder after one week.</p><p><strong>Results: </strong>A total of 431 practitioners responded (60% urologists, 40% gynecologists; 64% male; 34% aged 41-50). The majority worked in private practices (52%) and were trained in pelviperineology (61%). Regarding activity, 67% and 66% exceeded the thresholds for incontinence and pelvic organ prolapse (POP), respectively, but 18% and 18% did not meet them. Most incontinence procedures involved mid-urethral slings; 51% of respondents used only TVT, and 29% only TOT. For POP, sacrocolpopexy was the sole procedure performed by 9% of gynecologists and 61% of urologists. Among the latter, 59% did not perform Richter sacrospinous ligament fixation (vs. 6% of gynecologists). The perceived impact of the decrees was significant: 53% of practitioners (including 67% of urologists) reported a desire to withdraw from the management of female incontinence, and 46% from POP (including 79% of urologists). If authorization were lost, 71% would stop implanting meshes and 60% would refer patients elsewhere. Only 32% believed the thresholds would improve patient care. For 61% of practitioners, they did not guarantee individual experience, and for 51%, they did not reflect quality of care. Most respondents considered a threshold of 10 annual procedures more appropriate for POP and incontinence, and 78% believed that validation of specialized training would be more relevant than activity thresholds (78% among urologists).</p><p><strong>Discussion: </strong>This survey highlights a real risk of practitioner disengagement, particularly among urologists, potentially detrimental to healthcare provision. Thresholds are perceived as inadequate, and recognition of individual competence appears preferable.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103073"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947129","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":"Association between neurogenic bladder symptom score and disability status in multiple sclerosis patients.","authors":"Ana Silvia Vidal-Brandt, Alejandro Rivera-Chairez, Blayne Welk, Karina Villaseñor-Álvarez, Frida Sofia Teran-Amaya, Jorge Moreno-Palacios","doi":"10.1016/j.fjurol.2025.103061","DOIUrl":"10.1016/j.fjurol.2025.103061","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a chronic neurodegenerative disease that frequently causes neurogenic lower urinary tract dysfunction (NLUTD). More than 75% of patients experience urinary symptoms that negatively affect quality of life.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including 117 MS patients attending our neurourology clinic. The Neurogenic Bladder Symptom Score (NBSS) was administered, and clinical data, including the Expanded Disability Status Scale (EDSS), were collected. Spearman correlation was used to analyze the relationship between NBSS and EDSS. A receiver operating characteristic (ROC) curve determined the optimal NBSS cutoff for discriminating disability severity.</p><p><strong>Results: </strong>The NBSS showed a weak but significant correlation with EDSS (r=0.274, P=0.003). Patients with EDSS ≥5 had higher NBSS scores compared to those with EDSS <5 (median 24 vs 14, P=0.02). ROC analysis identified an NBSS cutoff of 18 points for distinguishing EDSS <5 from ≥5, with an area under the curve of 0.657 (95% CI: 0.56-0.75).</p><p><strong>Conclusion: </strong>The NBSS showed a significant correlation with EDSS, indicating that urinary symptom severity increases with neurological disability in patients with multiple sclerosis (MS). These results highlight the usefulness of NBSS as a complementary measure for assessing urinary dysfunction in MS.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103061"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688863","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 persistence of intradetrusor botulinum toxin in patients with multiple sclerosis.","authors":"Florian Patigny, Héléna Cassol, Bérangère Maillard, Jean-François Kaux, David Waltregny, Véronique Keppenne","doi":"10.1016/j.fjurol.2026.103094","DOIUrl":"10.1016/j.fjurol.2026.103094","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the persistence of intradetrusor botulinum toxin (BT) injections for the treatment of lower urinary tract dysfunction (LUTD) in patients with multiple sclerosis (MS).</p><p><strong>Materials and methods: </strong>This retrospective single-center study included patients treated with onabotulinumtoxin A injections between May 2005 and March 2024. Both descriptive and analytical analyses were performed. Patients were categorized according to their treatment response, injected dose, and neurological disability score (EDSS) to identify factors associated with treatment response.</p><p><strong>Results: </strong>A total of 124 patients (82% women; mean age: 54±11.5 years) were included, representing 1,159 injections. The median follow-up was 5 years [1-9]. The median initial EDSS was 5.5 [4-6.5], and the final EDSS was 6.5 [4.5-6.5]. Overall, 82.2% of patients were classified as good responders, and 6.45% as poor responders. Clean intermittent catheterization (CIC) was performed in 49.2% of patients before treatment, initiated in 29%, and never required in 21.8%. No significant differences were found between response groups (p>0.05). Thirty-six patients were lost to follow-up, thirty-three discontinued treatment (including twelve classified as treatment failures), and ten underwent surgery. No major complications were reported.</p><p><strong>Conclusions: </strong>In this real-life retrospective cohort, intradetrusor botulinum toxin injections were associated with long-term treatment persistence in patients with multiple sclerosis. These results provide complementary data on treatment continuation and response profiles in routine clinical practice.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":516865,"journal":{"name":"The French journal of urology","volume":" ","pages":"103094"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367840","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}