The Canadian journal of urology最新文献

{"title":"Evaluating surgical smoke in laser-assisted laparoscopic partial nephrectomy with a novel handle: anin Vitrostudy.","authors":"Long Ma, Tao Li, Ruohao Sun, Quan Du, Dali Jiang, Dalin He, Xiaoliang Fu, Nan Li, Xiaofeng Xu, Guoxiong Liu","doi":"10.32604/cju.2026.070096","DOIUrl":"https://doi.org/10.32604/cju.2026.070096","url":null,"abstract":"<p><strong>Objectives: </strong>Lasers show promising application in partial nephrectomy due to their excellent hemostatic effect. This study aimed to evaluate the suction effect of the novel laser operating handle on the smoke generated by a 980-nm diode laser (DL) and a 532-nm potassium-titanyl-phosphate (KTP) green laser (GL) in laparoscopic partial nephrectomy (LPN) and to analyse the surgical smoke generated by the laser treatment.</p><p><strong>Methods: </strong>Fresh porcine kidneys were purchased from a slaughterhouse. Electrocoagulation knife (EK), ultrasonic knife (UK), DL, and GL were utilised in LPN. The operation time and the composition and concentration of the surgical smoke were recorded. HE staining was performed to observe the degree of thermal damage.</p><p><strong>Results: </strong>In terms of smoke generation, the 532-nm KTP laser results in the largest amount of smoke. The surgical field of DL-LPN was adequately improved with the aid of the instrument with the novel handle. The thickness of the coagulation layer, which ranged from thick to thin, was DL, GL, EK, and UK. The coagulation of EK, UK, DL, and GL was 0.35 ± 0.08 mm, 0.52 ± 0.08 mm, 4.16 ± 0.21 mm, and 1.55 ± 0.21 mm, respectively. For formaldehyde, total volatile organic compounds (TVOC), and carbon monoxide (CO), there was a marked reduction after the application of the aspirator. For the DL group, the Formaldehyde TVOC and CO were 4.95 ± 0.48 mg/m3 and 1.69 ± 0.46 mg/m3, 8.34 ± 0.72 mg/m3 and 1.11 ± 0.33 mg/m3, 124.14 ± 9.58 PPM and 23.71 ± 3.9 PPM, respectively.</p><p><strong>Conclusions: </strong>As shown in the present study, though a large amount of harmful smoke was generated during laser-assisted laparoscopic partial nephrectomy (LALPN), the novel laser handle can be sucked effectively and provides a clear surgical field. As to the harmful gases released, an effective protective mask is needed.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"943-950"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876797","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":"Safety and outcomes of salvage HoLEP after TURP: a comparative study.","authors":"Volkan Sabur, Abdullah Gölbaşı","doi":"10.32604/cju.2026.074330","DOIUrl":"https://doi.org/10.32604/cju.2026.074330","url":null,"abstract":"<p><strong>Background: </strong>Recurrent prostate surgery may pose additional challenges for achieving an efficient and anatomically precise enucleation. This research investigates how prior transurethral resection of prostate (TURP) affects the perioperative course, functional outcomes, and technical difficulty of Holmium Laser Enucleation of the Prostate (HoLEP) when performed as a primary procedure versus as a salvage treatment.</p><p><strong>Methods: </strong>In this retrospective study, 174 patients who underwent HoLEP between August 2023 and April 2025 were analyzed. Group 1 included 137 patients undergoing primary HoLEP, and group 2 included 37 patients undergoing HoLEP for TURP recurrence. Outcomes assessed included enucleation weight, enucleation and morcellation time and efficiency, blood transfusion, catheter removal, and three-month postoperative International Prostate Symptom Score (IPSS), quality of life (QoL), incontinence, and urethral stricture rates.</p><p><strong>Results: </strong>Mean age was comparable between groups (group 1: 67.84 ± 8.67 vs. group 2: 67.24 ± 8.66 years; p = 0.840). Preoperative prostate volume and enucleation weight were higher in group 2 (81.24 vs. 67.34 mL, p = 0.012; enucleation weight, p = 0.037), while enucleation and morcellation times and efficiencies were similar. At three months, IPSS (8.31 vs. 7.19), QoL (1.56 vs. 1.58), incontinence, and urethral stricture rates did not differ significantly.</p><p><strong>Conclusion: </strong>With meticulous surgical planning, HoLEP represents a safe and effective salvage procedure following TURP, maintaining functional outcomes comparable to primary intervention.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"841-849"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877144","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":"Prostatic morcellation after HoLEP Enucleation: efficiency and safety of Storz DrillCut vs. Jena Surgical Multicut Solo.","authors":"Lucas Bergadá, Jonatan Reyes Olivera, Federico Ignacio Tirapegui, Christian Cristallo, Diego Santillán, Guillermo Montelli Yanzi, Melissa Segura, José Ramos, Ignacio Tobia, Mariano Sebastián González","doi":"10.32604/cju.2026.077406","DOIUrl":"10.32604/cju.2026.077406","url":null,"abstract":"<p><strong>Backgrounds: </strong>Holmium laser enucleation of the prostate (HoLEP) is a widely accepted technique for treating benign prostatic hyperplasia (BPH). Developed in the 1990s, its safety and efficiency have improved with adenoma morcellation. Multiple morcellation devices exist, with oscillatory systems offering higher efficiency and safety. Notable among these are the DrillCut Storz™ (DC) and the Multicut SOLO Jena Surgical™ (MC). Currently, evidence on the efficiency of MC is limited, and no comparative analysis exists between oscillatory morcellators. The objective of this study is to compare the morcellation efficiency (g/min) of the DC and the MC. A secondary objective was to assess intraoperative injury rates associated with both morcellators.</p><p><strong>Methods: </strong>Prospective, observational, non-randomised cohort that included patients over 40 years old with a surgical indication for BPH, recruited from the Urology Department at Hospital Italiano de Buenos Aires (October 2023-June 2024). Dependent variables analyzed were morcellation efficiency and complications whereas independent variables were age, surgical time, PSA, prostate volume, PSA density, prior medication, urinary catheter use, and prostate cancer findings.</p><p><strong>Results: </strong>A total of 264 patients were included (mean age: 70.1 years). The DC group had 98 patients whilst the MC group had 165 patients. Average morcellation time was 7.3 min (DC) and 9.1 min (MC) (p = 0.110). Mean adenoma weight morcellated was 49.9 g (DC) vs. 69.4 g (MC) (p < 0.001). Efficiency (g/min) was 10.5 (MC) vs. 8.3 (DC) (p < 0.001). Average surgical time was 84.4 min (DC) vs. 82 min (MC) (p = 0.541). Four intraoperative complications occurred in the DC group (4.1% vs. 0%; p = 0.005). All were minor bladder lacerations without postoperative management changes.</p><p><strong>Conclusions: </strong>The MC demonstrated superior efficiency and a lower rate of complications. However, incidence of complications was low in both groups, supporting the safety of both devices.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"819-826"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877139","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":"At a glans: metastatic prostate cancer disguised as penile squamous cell carcinoma; a case report.","authors":"Ramya Narasimhan, Kikuye Sugiyama, Joanna Wang, Ricardo Munarriz, Carmen Sarita-Reyes","doi":"10.32604/cju.2026.072310","DOIUrl":"https://doi.org/10.32604/cju.2026.072310","url":null,"abstract":"<p><strong>Background: </strong>The incidence rate of prostate adenocarcinoma in the United States was 112 per 100,000 in 2019. Men aged 65 to 74 years had a higher incidence rate (638 per 100,000), and 70% of the cases were detected locally (confined to the primary site) per the United States Cancer Statistics. While rare, prostate adenocarcinoma metastasis to the penis has variable presentation and potentially atypical histology that may require immunohistochemical, biomarker, and genetic analysis for confident diagnosis.</p><p><strong>Case description: </strong>We present a 56-year-old patient with advanced prostate cancer post-chemoradiation and androgen deprivation therapy with an uncommon site of metastasis to the penis. The clinical presentation and progression of the disease led to surgical removal and frozen section analysis. Initial pathologic assessment proved equivocal in the distinction between metastatic prostatic carcinoma versus primary penile squamous cell carcinoma. Diagnostic difficulty due to ambiguous histomorphological features was attributed to the loss of intrinsic prostatic protein markers in metastatic post-treatment cases. Immunohistochemistry and detailed biomarker analysis eventually aided diagnosis.</p><p><strong>Conclusions: </strong>This report illustrates some of the gross and microscopic histological ambiguity that can obfuscate immediate diagnostic certainty of origin of rapidly growing cutaneous penile lesion in the context of existing prostate cancer, while elaborating on immunohistochemical and genetic markers that can increase otherwise elusive diagnostic certainty. Early patient education and intervention represent sites of potential improvement in management of similar cases.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"1007-1017"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876168","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":"Outcomes following surgical management of urinary stone disease in older patients.","authors":"Jonathan J Song, I-Chun Jinn Thomas, Amber Herbert, Calyani Ganesan, Alan C Pao, Timothy Chang, Ryan R Sun, John T Leppert, Simon L Conti","doi":"10.32604/cju.2026.074683","DOIUrl":"https://doi.org/10.32604/cju.2026.074683","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of urinary stone disease (USD) is increasing among older patients. Data examining the association between patient age and clinical outcomes following surgical treatment for USD are limited. Our objective was to assess the safety profiles of ureteroscopy (URS), extracorporeal shock wave lithotripsy (ESWL), and percutaneous nephrolithotomy (PCNL) for USD by age in an older patient population.</p><p><strong>Methods: </strong>We retrospectively identified all patients who underwent URS, ESWL, and PCNL for USD from 2010 to 2019 in the Veterans Health Administration. We fit multivariable logistic regression models to determine the association between age and post-procedure sepsis, hospital readmission, and all-cause mortality within 30 days of admission.</p><p><strong>Results: </strong>We identified 50,519 procedures for USD, including 41,216 URS (81.6%), 5741 ESWL (11.4%), and 3562 PCNL (7.1%). Overall, increasing age was associated with post-operative sepsis (aOR per five-year increase 1.02; 95% CI: 1.00-1.05), hospital readmission (aOR = 1.02, 95% CI: 1.01-1.04), and all-cause mortality within 30 days (aOR = 1.19, 95% CI: 1.10-1.29). Among URS cases, increasing age was significantly associated with sepsis (aOR = 1.03, 95% CI: 1.00-1.05), hospital readmission (aOR = 1.03, 95% CI: 1.01-1.05), and all-cause mortality (aOR = 1.19, 95% CI: 1.09-1.30) within 30 days. We detected no association between increasing age and adverse outcomes following ESWL or PCNL. Limitations include a lack of data on the type of stone disease and analysis of predominantly older male veterans, potentially limiting generalizability.</p><p><strong>Conclusions: </strong>Following URS, age was independently associated with sepsis, hospital readmission, and all-cause mortality within 30 days of admission. This association was not found in patients who underwent ESWL or PCNL. Additional preoperative risk counseling and medical optimization may be beneficial in older patients undergoing URS.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"903-912"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877075","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":"Prostate volume on transrectal ultrasound: comparing ultrasounds performed by urologists to radiologists.","authors":"Marie-Elise Henckes, Ben Van Cleynenbreugel","doi":"10.32604/cju.2026.072379","DOIUrl":"https://doi.org/10.32604/cju.2026.072379","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the precision of transrectal ultrasound (TRUS) measurement of the prostate volume when performed by a urologist compared with a radiologist. To date, no prior research has directly compared the accuracy of prostate volume measurements between these two groups.</p><p><strong>Methods: </strong>A retrospective study was conducted using data from 307 men who underwent enucleation of the prostate between 2020 and 2022 in two Belgian hospitals (University Hospital Leuven and Maria Middelares Hospital [Ghent]). A comparison was made between the prostate volume measured on ultrasound pre-operatively and the measured resected volume after enucleation. We compared these differences in volume in men who had their ultrasound performed by a urologist (N = 114), those who had it performed by a radiologist (N = 175), and those who had an MRI pre-operatively as a measurement (N = 18).</p><p><strong>Results: </strong>A multivariate regression to predict measured prostate volume was performed with age, estimated prostate volume, and pathology result as predictors, which was significant at α = 0.05, F(3, 302) = 168.104, p < 0.001, RAdjusted2 = 0.686. Adding the imaging modality (ultrasound performed by a urologist or radiologist, or MRI) to the base model did not significantly improve the prediction of measured prostate volume, F-change(3, 299) = 0.367, p = 0.777. Seven outliers were identified (|Z-score| > 2), of which six measurements were performed by resident urologists (N = 19) and one by a certified urologist (N = 95).</p><p><strong>Conclusion: </strong>This study demonstrates no evidence that prostate volume measurements performed by radiologists using ultrasound are more accurate than those performed by urologists. The higher number of outliers among resident urologists likely reflects the well-known learning curve associated with prostate ultrasound and highlights the importance of standardized training.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"811-817"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877167","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":"Efficacy and safety of blue laser vaporization of the prostate for benign prostatic hyperplasia: a systematic review and meta-analysis.","authors":"Ren-Peng Yu, Ou-Yang Song, Hong Weng, Yong-Bo Wang, Bing-Hui Li, Hao Zi, Yu Hao, Qiang Li, Xian-Tao Zeng","doi":"10.32604/cju.2026.079426","DOIUrl":"10.32604/cju.2026.079426","url":null,"abstract":"<p><strong>Objective: </strong>While novel 450 nm blue laser vaporization of the prostate (BLVP) has emerged as a promising treatment for benign prostatic hyperplasia (BPH), comprehensive evidence-based validation remains lacking. Therefore, this study aims to evaluate the efficacy and safety of BLVP for BPH.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang database up to 1 September 2025 (an updated search was performed on 31 December 2025). Single-arm meta-analyses summarized the absolute efficacy and safety of BLVP. For the comparison of BLVP with other surgical procedures, head-to-head meta-analyses or descriptive systematic reviews were performed based on the homogeneity of studies.</p><p><strong>Results: </strong>Across 23 included studies (1713 participants), single-arm meta-analysis showed favorable perioperative outcomes: mean operative time (26.46 min), bladder irrigation time (14.96 h), catheterization time (2.67 d), and hemoglobin drop (6.96 g/L). Postoperative IPSS, Qmax, PVR, and QoL significantly improved with low complication rates. Compared with transurethral resection of the prostate (TURP), BLVP demonstrated favorable outcomes regarding shorter operation, irrigation, and catheterization times, less hemoglobin loss, and shorter hospital stays (all p < 0.05). While urinary functional recovery was comparable, BLVP exhibited lower risks of urinary incontinence (OR = 0.38) and secondary bleeding (OR = 0.15). Additionally, BLVP better preserved sexual function, demonstrating higher International Index of Erectile Function-5 (IIEF-5) scores at 6 months and a significantly lower incidence of retrograde ejaculation (OR = 0.07) than TURP. Preliminary studies suggest that the efficacy of BLVP is similar to that of 1470 nm and greenlight lasers.</p><p><strong>Conclusion: </strong>Preliminary evidence suggests that BLVP appears to be a safe and effective minimally invasive procedure for BPH, demonstrating favorable trends in perioperative recovery and sexual function preservation. However, due to a lack of high-quality RCTs and low-to-moderate certainty of evidence, BLVP's equivalence or superiority to TURP remains inconclusive, warranting further large-scale trials.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"753-770"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876865","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":"Anin vitro, proof of concept study utilizing a latex model to simulate assessment of urethral pressure profile to quantify tissue compliance and stricture detection.","authors":"Diboro L Kanabolo, Noah Roselli, Emily Ji, Yashwanth Nanda Kumar, Neelesh A Patankar, Ziho Lee","doi":"10.32604/cju.2026.079668","DOIUrl":"https://doi.org/10.32604/cju.2026.079668","url":null,"abstract":"<p><strong>Background: </strong>Retrograde urethrogram (RUG) remains the gold standard for diagnosing urethral stricture disease, however no widely available diagnostic modality currently quantifies stricture characteristics using cross-sectional area or tissue compliance. We hypothesized that pressure-derived metrics could improve diagnostic accuracy and guide treatment. We aimed to develop an in vitro latex urethra model to simulate \"healthy\" and \"strictured\" states and directly measure luminal pressure as an initial step toward compliance assessment.</p><p><strong>Methods: </strong>Ten 20-cm latex tubes were studied; five contained 1.5-cm simulated strictures. All tubes were clamped at both ends to prevent leakage. Strictures were created by clamping across an 8Fr bougie at the midpoint, while healthy models were left unclamped at the 8Fr bougie location. Tubes were pressurized for 10 s to simulate RUG conditions. Pressure was measured using a 7Fr air-charged dual-sensor urodynamic catheter positioned such that the midpoint stricture was located 2 cm distal to the first pressure sensor. Saline was infused at 20 mL/min through the catheter port positioned proximal to the stricture, and maximum pressure (Pmax, cmH2O) was selectively recorded only from the first proximal sensor to reflect upstream resistance generated by the narrowing. Time to maximum pressure (Tmax, seconds) was also measured. Compliance was calculated (ΔV/ΔP). Comparisons were performed using an unpaired Student's t-test.</p><p><strong>Results: </strong>Ten pressure-time curves were generated. Mean (Standard Deviation) Pmax was significantly higher in strictured models compared to healthy controls (160.8 [9.4] vs. 29.8 [16.4] cmH2O, p < 0.001). Tmax was similar between groups (9.2 [1.1] vs. 9.8 [0.4] s, p = 0.289). Compliance was lower in strictured (0.019 [0.003] cm³/cmH2O) vs. healthy tubes (0.150 [0.107] cm³/cmH2O, p = 0.025).</p><p><strong>Conclusions: </strong>This proof-of-concept model demonstrates that pressure profiling can distinguish healthy from strictured urethras and supports compliance as a novel diagnostic metric.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"951-958"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877138","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":"Testicular prosthesis complications and satisfaction rates after gender affirming scrotoplasty.","authors":"Liliana Guadagni, Marco Falcone, Lorenzo Cirigliano, Ilaria Ferro, Mirko Preto, Natalia Plamadeala, Martina Scavone, Emanuele Zupo, Paolo Gontero","doi":"10.32604/cju.2026.076284","DOIUrl":"https://doi.org/10.32604/cju.2026.076284","url":null,"abstract":"<p><strong>Background: </strong>Testicular prosthesis implantation (TPI) is frequently performed as part of masculinizing genital gender-affirming surgery (GGAS), but complication and satisfaction data for assigned female at birth (AFAB) men remain limited. We report a single-centre experience assessing postoperative complications, explantation-free survival (EFS) and patient-reported satisfaction.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including all patients who underwent unilateral or bilateral transmasculine TPI (TM-TPI) from May 2007 to April 2025. Primary outcomes were postoperative complications (e.g., surgical-site infection, contamination, hematoma, migration, pain, extrusion) and EFS rate. Satisfaction was measured at 12 months using the 13-item Transmasculine Testicular Prosthesis Satisfaction Index (TM-TPSI), a questionnaire tool developed for this cohort.</p><p><strong>Results: </strong>Forty-four patients (mean age 40 ± 10 years) received solid silicone prostheses; median follow-up was 84.5 (IQR 65.3-95.0) months. Complications included superficial surgical-site infection in 8/44 (18%), one prosthesis contamination requiring removal, one extrusion requiring replacement, and one migration requiring repositioning (2%). Mean time to explant/reposition was 57.7 ± 61.5 months; the 5-year EFS rate was 97%. Of 41 respondents to the TM-TPSI, 84% were \"mostly satisfied\" or \"more satisfied than unsatisfied\"; the mean score was 46.0 ± 10.5.</p><p><strong>Conclusions: </strong>In this cohort, TM-TPI showed a low rate of surgical revisions and high patient-reported satisfaction over long-term follow-up. Multicentre studies and formal validation of the TM-TPSI are warranted to refine benchmarks and enable cross-cohort comparisons. TM-TPI is a procedure that needs to be further investigated with clear specificity for AFAB men.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"913-921"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877243","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":"Button Cistostomy in pediatric population: a simplified mini-inivasive insertion technique.","authors":"Giovanni Mosiello, Martina Monti, Rebecca Pulvirenti, Noemi Deanesi, Antonio Maria Zaccara, Chiara Pellegrino, Maria Luisa Capitanucci","doi":"10.32604/cju.2026.079335","DOIUrl":"https://doi.org/10.32604/cju.2026.079335","url":null,"abstract":"<p><p>Pediatric patients with functional or anatomical lower urinary tract obstruction, including neurogenic bladder, require effective bladder drainage to maintain low intravesical pressures, prevent infections, and preserve renal function. Clean intermittent catheterization (CIC) is the standard approach, but it is not always feasible due to patient- or anatomy-related factors. In these cases, continent or non-continent urinary diversion techniques are considered. Among non-continent options, vesicostomy has traditionally been used but is associated with significant morbidity and long-term complications. The cystostomy button (CB), originally developed for enteral feeding, has emerged as a minimally invasive, catheterizable alternative for bladder drainage. Current evidence and clinical experience suggest that CB placement is well tolerated by patients and caregivers, easy to manage, and effective in maintaining reliable bladder emptying without compromising detrusor function. Furthermore, endoscopic placement techniques enhance procedural safety while reducing invasiveness. This study aims to describe our personal modified endoscopic technique used for CB placement, when CIC is not feasible.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"795-798"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876712","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}