The Canadian journal of urology最新文献

{"title":"Impact of the 2024 national medical fluid shortage on urologic practice in the United States: a cross-sectional survey.","authors":"Lucas B Vergamini, Pedro Z Padovani, Nicholas Choi, Wilson R Molina, Donald Neff, David A Duchene, Emily Elliott, Colby Souders, Maxton Thoman, Bristol B Whiles","doi":"10.32604/cju.2026.078800","DOIUrl":"https://doi.org/10.32604/cju.2026.078800","url":null,"abstract":"<p><strong>Objectives: </strong>In September 2024, Hurricane Helene caused extensive infrastructure damage in the United States, including severe disruption to a major Baxter sterile irrigation fluid manufacturing facility in North Carolina, leading to a nationwide shortage of sterile irrigation fluids used in surgical procedures. The objective of this study was to evaluate the impact of the nationwide sterile irrigation fluid shortage on urologic practice across the United States (U.S.).</p><p><strong>Methods: </strong>A descriptive, cross-sectional Research Electronic Data Capture (REDCap) survey was distributed to U.S. urologists. The questionnaire captured provider demographics, procedure delays, and practice/procedure modifications.</p><p><strong>Results: </strong>Ninety-five surgeons responded. Overall, 76.8% reported an impact on practice, and 47% were directed by hospitals to cancel or reschedule cases. Over one-third rescheduled more than 10 procedures, with a median delay of two months. Benign prostatic hyperplasia (BPH) treatments and percutaneous nephrolithotomy (PCNL) were the most affected. About 36% noted a negative impact on physician-patient relationships. Nearly half (45.7%) modified outpatient procedures, primarily cystoscopies, using syringe irrigation or requesting patients arrive with full bladders.</p><p><strong>Results: </strong>Surgical adjustments (40.4%) included switching from holmium laser enucleation of the prostate (HoLEP) to simple prostatectomy and reducing resident involvement. Postoperatively, increased catheter traction was used to limit irrigation. Twenty-nine urologists planned to retain conservation measures such as smaller fluid bags or reduced pressurized irrigation. At survey completion, 32.6% still experienced effects of the fluid shortage.</p><p><strong>Conclusions: </strong>The 2024 national fluid shortage significantly disrupted U.S. urology practice, especially endourology cases. Urologists adopted a range of clinical and surgical strategies, some of which may persist, underscoring the need for systemic preparedness to mitigate future shortages.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"967-975"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877082","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":"Clinical and urodynamic indicators of non-response to OnabotulinumtoxinA in idiopathic overactive bladder.","authors":"Samer Shamout, Hani Kabbara, Claudia Covarrubias, Jacques Corcos, Lysanne Campeau","doi":"10.32604/cju.2026.073432","DOIUrl":"https://doi.org/10.32604/cju.2026.073432","url":null,"abstract":"<p><strong>Background: </strong>Onabotulinum toxin-A (BoNT/A) intradetrusor injection is an established, effective, and safe treatment for overactive bladder (OAB) refractory to anticholinergics. Although primary non-response to BoNT/A is infrequent, it remains clinically relevant. We investigated whether baseline clinical, demographic, or urodynamic characteristics could predict non-responders prior to treatment.</p><p><strong>Methods: </strong>A Retrospective analysis of 65 consecutive refractory idiopathic OAB (I-OAB) male and female patients treated with 100 U BoNT/A at Jewish General Hospital between 2005 and 2015 was conducted. Response defined as >30% increase in maximum cystometric bladder capacity (MCBC) at 12 weeks, confirmed clinically and through urodynamic studies (UDS). Non-response was verified by lack of improvement after the second intradetrusor injection.</p><p><strong>Results: </strong>A total of 13 men and 52 women with a mean age of 70 years (range 21 to 94) were studied. At 12 weeks, 63% (41/65) of patients demonstrated a significant response in both symptoms and UDS (p < 0.05), while 37% (24/65) were non-responders. Non-responders exhibited significantly higher baseline first desire to void volume (FDV) and postvoid residual urine (PVR) (p < 0.05), with a trend toward greater bladder compliance (18.8 ± 15.1 vs. 13.3 ± 9.4 cmH2O, p = 0.09). Multivariate logistic regression identified no independent predictors of response.</p><p><strong>Conclusions: </strong>Elevated baseline FDV and PVR are associated with poor response to 100 U BoNT/A in refractory I-OAB patients.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"873-883"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876791","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":"HypnoVR®in minimally invasive surgical techniques (MISTs) for lower urinary tract symptoms (LUTS): a safe, sedation-reducing tool improving patient experience.","authors":"Alberto Olivero, Sofia Giudici, Alberto Caviglia, Erika Palagonia, Marco Nizzardo, Alberto Quistini, Andrea Grasso, Ofir Maltzman, Marco Colombo, Stefano Tappero, Elio Mazzone, Paolo Dell'Oglio, Aldo Massimo Bocciardi, Antonio Galfano, Silvia Secco","doi":"10.32604/cju.2026.076804","DOIUrl":"https://doi.org/10.32604/cju.2026.076804","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical techniques (MISTs) are becoming an increasingly popular outpatient treatment option for lower urinary tract symptoms. Although generally well-tolerated, MISTs may cause periprocedural discomfort. Virtual reality devices (VRDs) have been shown to reduce patient-reported pain during several procedures. This study aims to evaluate whether the use of VRD during MISTs could improve perioperative endovenous sedation needs of a VRD during MISTs in a case-control design.</p><p><strong>Methods: </strong>We retrospectively analyzed patient data from MISTs performed between January 2024 and July 2025 at a single referral center (ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy). Procedures were conducted with or without a VRD (HypnoVR®, Strasbourg, France), based on patient preference and device availability. Patients were grouped into MISTs without VRD (group 1) and MISTs with VRD (group 2). Periprocedural data, endovenous sedation needs, Visual Analogue Scale (VAS) score for pain, use of additional painkiller drugs after the procedure, and complication rate have been addressed.</p><p><strong>Results: </strong>Twenty-one procedures with VRD and 66 control procedures were analyzed. Groups were comparable in age, prostate volume, PSA, indwelling catheter presence, and type of MIST. Median (IQR) prostate volume was 41 (30-56) mL in group 1 and 36 (30-45) mL in group 2. MIST distribution was similar, though iTIND procedures were more frequent with VRD. Endovenous sedation rate was higher in group 1 (86.4 vs. 38.1%, p < 0.001). Median (IQR) VAS scores were 2 (1-2) in group 1 and 1.5 (1-2.75) in group 2. No VRD-related side effects or procedure interruptions occurred.</p><p><strong>Conclusion: </strong>This is the first study demonstrating the safety, feasibility, and tolerability of VRD use during MISTs. Although VRD did not significantly reduce pain scores, it markedly decreased endovenous sedation use, potentially facilitating faster recovery and discharge. VRD may be considered for patients undergoing MISTs where available.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"959-965"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876940","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":"LEGENDS IN UROLOGY.","authors":"Gerald Jordan","doi":"10.32604/cju.2026.089942","DOIUrl":"https://doi.org/10.32604/cju.2026.089942","url":null,"abstract":"","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"731-734"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877117","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":"The estimated economic burden of urinary incontinence-related complications in older adults Canada.","authors":"Crystal Su, Barrett Carley, Casandra Gardner, Andrea Shepherd, Adrian Wagg","doi":"10.32604/cju.2026.079016","DOIUrl":"10.32604/cju.2026.079016","url":null,"abstract":"<p><strong>Backgrounds: </strong>Urinary incontinence (UI) is increasingly prevalent, particularly in older adults. UI management is frequently under-resourced and is associated with the development of potentially avoidable complications, placing a significant burden on the patient and on the healthcare system. This study aimed to estimate the cost of UI-related complications in Canada.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review using PubMed, Canadian Institute for Health Information (CIHI) data and citation mining to identify the prevalence of UI, UI-related complications, and associated treatment costs across each of acute care, long-term care (LTC), homecare and self/family care. UI-related complications quantified included: urinary tract infections (UTI), catheter-associated UTI, incontinence-associated dermatitis (IAD), UI-related pressure ulcers (PU), slips and falls, and fall-related injuries. The total economic burden to the Canadian healthcare system was estimated using UI prevalence, complication rates, and costs of treating complications in each setting.</p><p><strong>Results: </strong>The estimated number of older Canadians with UI totaled 2,338,503 with an annual economic burden of UI-related complications up to $1,654,875,326. Acute care had the highest cost (up to $1,190,494,315), driven by skin-related complications (up to $525,692,182 for PU and $471,461,636 for IAD). Fall-related injuries, followed by UTIs, imposed the highest cost in LTC, homecare and self/family care, totaling up to $309,141,175 and $126,305,519, respectively. LTC had the lowest overall complication burden (up to $49,408,153), roughly one-third the cost in homecare, and one-fifth the cost in self/family care.</p><p><strong>Conclusions: </strong>UI and its associated complications represent a substantial economic burden to the Canadian healthcare system. This underscores the need for improved UI management strategies to contain associated costs.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"893-902"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877228","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":"The 10,000 Hour Rule, Robotics and the Evolving Lifespan of a Urologic Career.","authors":"Kevin R Loughlin","doi":"10.32604/cju.2026.085422","DOIUrl":"https://doi.org/10.32604/cju.2026.085422","url":null,"abstract":"","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"729-730"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877220","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":"Artificial intelligence advances in cystoscopy and imaging for bladder cancer: a narrative review.","authors":"Usman Khalid, Nikhil Shah, Rajesh Kavia, Deepak Batura","doi":"10.32604/cju.2026.074820","DOIUrl":"https://doi.org/10.32604/cju.2026.074820","url":null,"abstract":"<p><p>Bladder cancer (BCa) diagnosis relies heavily on cystoscopy and imaging. Both have limited sensitivity and accuracy, particularly for muscle-invasive disease. Artificial intelligence (AI) has emerged as a promising tool for improving detection, grading, and staging by extracting imaging features that exceed human perception. We conducted a narrative review of peer-reviewed, English-language studies published between 2015 and 2025. We identified 75 articles and synthesized data from 35 key studies retrieved via PubMed, Google Scholar, Scopus, and Embase. Data were synthesized narratively, emphasizing diagnostic performance, clinical relevance, and study limitations. In cystoscopy, AI models achieved high accuracy in tumour detection and grading, including carcinoma in situ, and in some studies reduced missed lesions by >20% compared with expert urologists; CystoNet-T reported an average precision of 91.4%. Performance varied across studies, with inconsistencies driven by methodological factors: endoscopic acquisition conditions (illumination quality; white-light vs. enhanced imaging), variation in ground truth and annotation (histopathology vs. expert-labelled frames), dataset size and class imbalance, model architecture and preprocessing pipelines, and validation strategy (internal splits vs. external testing). Most evidence remains limited by retrospective, single-center datasets, which restrict generalizability. In imaging, AI applications showed modality-dependent performance. CT-based radiomic and deep-learning models demonstrated the most consistent improvements for grading, staging, and recurrence prediction across several studies. MRI and radiogenomic models demonstrated proof-of-concept associations between imaging features and molecular profiles. However, clinical readiness is limited by small cohorts and a lack of prospective validation. Results were also affected by scanner heterogeneity and reader dependence. Evidence for PET/CT remains sparse and preliminary. Many approaches outperformed conventional clinical models, including a vision transformer (ViT)-based MRI model for muscle invasiveness prediction (AUC = 0.872). Methodological heterogeneity restricted generalisability. AI shows potential to reduce diagnostic variability and improve initial treatment planning in BCa. Nonetheless, prospective multicentre trials with standardised methodology are essential before clinical integration. In parallel, regulatory approval of AI as medical software, real-time workflow integration within cystoscopy suites and radiology systems, data governance and patient privacy, and ongoing post-deployment performance monitoring must be addressed to ensure safe and effective clinical use.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"735-752"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875972","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":"Pathologic failure and salvage approaches following focal therapy for localized prostate cancer.","authors":"Samuel Tremblay, Seyed Sajjad Tabei, Shima Tayebi, Benjamin H Hinrichs, Alon Lazarovich, Jason Koehler, Wei-Wen Hsu, Sadhna Verma, Abhinav Sidana","doi":"10.32604/cju.2026.075779","DOIUrl":"https://doi.org/10.32604/cju.2026.075779","url":null,"abstract":"<p><strong>Background: </strong>Focal therapy (FT) is an emerging treatment modality for localized prostate cancer. However, limited data are available regarding the patterns of oncologic failure post-FT. This study aims to characterize the features of oncologic failure and salvage strategies following FT.</p><p><strong>Methods: </strong>Patients presenting with pathologic failure (PF) after receiving FT (cryotherapy, High-intensity focused ultrasound, or irreversible electroporation) for intermediate-risk prostate cancer were selected from a prospective registry between 2018 and 2023. All patients underwent protocol-based follow-up, including PSA testing, multiparametric MRI, and mandatory biopsy. The primary outcome was PF, defined as biopsy-confirmed Grade Group ≥2 cancer post-treatment. Failures were classified as in-field or out-of-field based on lesion location relative to the ablation zone.</p><p><strong>Results: </strong>This study included 101 patients who underwent primary FT, with a median follow-up of 16.5 months. PF occurred in 18 patients (17.8%). Failures included 7 in-field, 9 out-of-field, and 2 involving both locations. Notably, 50% of recurrences had no suspicious findings on MRI, and 67% occurred without meeting Phoenix PSA criteria for biochemical recurrence. Failures were typically low-volume (mean longest positive core length 4.8 mm), and 11 were detected within the first 12 months of follow-up. Among those with PF, definitive salvage treatments included repeat FT (55.6%), active surveillance (16.7%), radical prostatectomy (11.1%), whole-gland ablation (5.6%), and radiation therapy (11.1%).</p><p><strong>Conclusions: </strong>Focal therapy is increasingly used for localized prostate cancer, but many failures occur without PSA rise or imaging abnormalities. These findings suggest that although PSA testing and imaging are valuable for surveillance after FT, biopsy remains essential.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"799-810"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877125","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":"450-nm blue laser vaporizationversustransurethral resection of the prostate for benign prostatic hyperplasia: a retrospective comparative study.","authors":"Nana Liu, Jinjin Zhang, Wanli Liu, Xiangbo Chen, Baoli Li","doi":"10.32604/cju.2026.084512","DOIUrl":"https://doi.org/10.32604/cju.2026.084512","url":null,"abstract":"<p><strong>Background: </strong>Transurethral resection of the prostate (TURP) remains the standard surgical treatment for benign prostatic hyperplasia (BPH), whereas laser-based procedures have increasingly been adopted as alternatives because of their potential advantages in hemostasis and postoperative recovery. This study compared coagulation depth, perioperative outcomes, postoperative complications, and short-term functional outcomes between 450-nm blue laser vaporization of the prostate (BVP) and TURP.</p><p><strong>Methods: </strong>This retrospective single-center study included 260 patients with BPH who underwent either TURP (n = 110) or BVP (n = 150). Coagulation depth was compared between the two procedures using an ex vivo porcine kidney specimen experiment. Baseline characteristics, perioperative variables, intraoperative and postoperative complications, and postoperative functional outcomes at 1, 3, and 6 months were analyzed.</p><p><strong>Results: </strong>BVP produced a significantly shallower coagulation depth than TURP. Baseline demographic and clinical characteristics were generally comparable between the two groups, although BMI and baseline QoL differed slightly. Compared with TURP, BVP was associated with a shorter operative time, earlier catheter removal, and a shorter hospital stay. Intraoperative complications were uncommon in both groups, and several postoperative complications were numerically less frequent in the BVP group. Both procedures resulted in substantial postoperative improvement in Qmax, PVR, IPSS, and QoL. In adjusted repeated-measures mixed-effects analyses, BVP showed greater improvement in Qmax and IPSS across follow-up and greater PVR reduction at 3 and 6 months, whereas QoL improved over time without a significant overall group effect.</p><p><strong>Conclusions: </strong>Compared with TURP, 450-nm BVP was associated with a shallower coagulation depth, more favorable perioperative recovery, and comparable short-term functional outcomes in patients with BPH. These findings support BVP as a feasible and promising transurethral alternative for the surgical management of BPH. The reduced coagulation depth observed after BVP may also have implications for postoperative inflammatory recovery and warrants further investigation.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"989-997"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877171","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":"Specialist consultation improves underdiagnosis of surgical adrenal incidentaloma: a TriNetX database investigation.","authors":"Aaron R Hochberg, Monika Shirodkar, Brian H Im, Xiaoying Deng, Fitsum T Hailemariam, Sohan S Shah, Rasheed A M Thompson, Francisco Aguirre, Patrick T Gomella, Mihir S Shah, Costas D Lallas, Adam R Metwalli","doi":"10.32604/cju.2026.069461","DOIUrl":"https://doi.org/10.32604/cju.2026.069461","url":null,"abstract":"<p><strong>Objectives: </strong>Despite practice guidelines recommending hormonal testing for all cases of incidentally discovered adrenal adenomas (incidentalomas), only 30% of patients receive laboratory workup. This study sought to evaluate hormonal testing and adrenal surgery rates in incidentaloma patients seen by a specialist (endocrinologist, nephrologist, urologist, or general surgeon), compared to those not seen by a specialist.</p><p><strong>Methods: </strong>We identified incidentaloma cases by querying the TriNetX Research Network for all adult patients with an unspecified adrenal mass occurring within 1 month following abdominal imaging. We compared those seen by a specialist against those not following an incidentaloma diagnosis. Primary outcomes were rates of hormonal testing and adrenal gland surgery.</p><p><strong>Results: </strong>Of 132,217 incidentaloma patients, 1054 (0.7%) received a specialist consultation. Referral to a specialist was associated with increased hormonal testing (49.5% vs. 28.0%, p < 0.0001) and adrenal surgery (6.3% vs. 3.6%, p < 0.0001). Surgery rates were similar among those who received hormonal testing, regardless of specialist consultation (12.6% vs. 13.3%, p = 0.8445). Of all incidentaloma patients, 6765 (5.2%) proceeded to adrenal surgery.</p><p><strong>Conclusions: </strong>Patients receiving specialist services experienced more hormonal testing and treatment with surgery. Surgery rates did not differ among those undergoing any hormonal evaluation, regardless of specialist status, indicating that about 13% of incidentaloma patients will require adrenal surgery. Applying this rate suggests that nearly 14,000 incidentaloma patients in TriNetX did not receive surgery despite likely meeting criteria, a significant failure in treatment. Further, prospective studies are needed to investigate practice patterns and expose reasons for the lack of progression to evaluation or treatment.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 4","pages":"931-941"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877156","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}