The Canadian journal of urology最新文献

{"title":"Virtual basket mode in HoLEP: reduced early dysuria and faster continence recovery without loss of efficacy.","authors":"Serkan Özcan, Mertcan Dama, Enis Mert Yorulmaz, Osman Köse, Sacit Nuri Görgel, Yiğit Akın","doi":"10.32604/cju.2025.072282","DOIUrl":"10.32604/cju.2025.072282","url":null,"abstract":"<p><strong>Objectives: </strong>Holmium laser enucleation of the prostate (HoLEP) is an established treatment for benign prostatic hyperplasia (BPH), but early postoperative dysuria and incontinence remain common concerns. The Virtual Basket (VB) mode has been proposed to reduce tissue trauma. This study evaluated whether VB use improves early postoperative recovery without compromising HoLEP efficacy.</p><p><strong>Methods: </strong>We retrospectively analyzed 168 men who underwent HoLEP between September 2023 and September 2024. Patients were categorized into three groups according to laser settings: 100 W Standard (n = 65), 100 W VB (n = 49), and 80 W VB (n = 54). The primary outcomes were postoperative dysuria and urinary incontinence at 1 and 3 months. Secondary outcomes included catheterization time, hemoglobin drop, surgical and energy efficiency, and perioperative complications. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify predictors of persistent incontinence.</p><p><strong>Results: </strong>At 1 month, dysuria occurred more frequently in the Standard group (32.3%) than in the VB groups (15.6%) (p = 0.037). This difference was resolved within 3 months. Persistent urinary incontinence at 3 months was significantly lower in the VB groups (2.0% and 1.9%) compared with the Standard group (9.2%) (p = 0.031). Surgical efficiency was higher with Standard HoLEP (2.63 g/min vs. 1.8 g/min, p = 0.035), while energy efficiency was comparable across groups. The 100 W VB group had shorter catheterization times (p < 0.001) and less hemoglobin loss (p = 0.004). Logistic regression identified prostate volume as an independent predictor of incontinence (odds ratio [OR] = 1.018, 95% CI: 1.001-1.034, p = 0.035). ROC analysis demonstrated moderate predictive accuracy (area under curve [AUC] = 0.776).</p><p><strong>Conclusions: </strong>VB-HoLEP significantly reduces early dysuria and accelerates continence recovery while maintaining safety and efficacy. These findings support the routine use of VB mode to improve postoperative recovery and patient satisfaction.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"377-386"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848847","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 the severity of acute renal colic episodes and clinical, laboratory, and imaging parameters.","authors":"Kai Dang, Teng Cui, Yongan Zhou, Jiayuan Ji, Yang Yang, Xiangyu Wang, Jing Xiao","doi":"10.32604/cju.2026.068291","DOIUrl":"10.32604/cju.2026.068291","url":null,"abstract":"<p><strong>Objectives: </strong>Although renal colic is a well-known acute manifestation of urolithiasis, the relationship between its pain severity and a range of clinical parameters has not been clearly established by comprehensive studies. This study aimed to construct and validate a simple and accurate clinical nomogram for predicting the occurrence of more intense acute renal colic (ARC) in patients with urolithiasis.</p><p><strong>Methods: </strong>The development and validation of the prediction model followed the reporting standards outlined in the TRIPOD checklist. A retrospective analysis was conducted on 285 patients who visited the Department of Urology at Beijing Friendship Hospital, Capital Medical University, from March 2024 to November 2024. Propensity score matching (PSM) of the raw observational data was conducted. This study utilized univariate, multivariate logistic, and linear regression analysis to screen and evaluate the risk factors for ARC pain intensity and constructed a predictive model. An evaluation was performed using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Univariate analysis after PSM and linear logistic regression analysis identified independent risk factors for higher Visual Analog Scale (VAS) scores: serum creatinine (β-Coefficient = 0.364, 95% CI: 0.117-0.610, p = 0.005), pyuria (β-Coefficient = 0.273, 95% CI: 0.006-0.548, p = 0.042), hydronephrosis (β-Coefficient = 0.128, 95% CI: 0.073-0.254, p = 0.007), CRP levels (β-Coefficient = 0.311, 95% CI: 0.113-0.582, p = 0.018), and urinary bacteriuria ≥5/HPF (β-Coefficient = 0.324, 95% CI: 0.074-0.641, p = 0.018). The nomogram model demonstrated good accuracy with an AUC value of 0.964, and in the validation cohort, the AUC value was 0.969. The calibration curve indicated a better consistency between the predictive model and the actual occurrence of more intense ARC in patients with urolithiasis. The decision curve analysis showed favorable clinical utility.</p><p><strong>Conclusion: </strong>Serum creatinine, pyuria, hydronephrosis, CRP levels, and urinary bacteriuria ≥5/HPF are independent risk factors for higher VAS scores. The constructed predictive model based on these factors effectively assesses the risk of more intense ARC in patients with urolithiasis.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"403-415"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848940","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":"Genetic evidence for associations between food intake and prostatic diseases: a Mendelian randomization study.","authors":"Xiangyu Chen, Congzhe Ren, Lijun Xie, Xiaoqiang Liu","doi":"10.32604/cju.2025.069578","DOIUrl":"10.32604/cju.2025.069578","url":null,"abstract":"<p><strong>Background: </strong>Regional differences in the incidence of prostate cancer (PCa) and prostatitis may be due to different food intake. But which foods affect PCa and prostatitis development or progression remains controversial. This study aims to explore the causal relationship between PCa and prostatitis and 30 different foods using two-sample Mendelian randomization (MR) and multivariable MR (MVMR) analysis.</p><p><strong>Methods: </strong>Data on 30 different foods were screened from the UK Biobank. PCa data came from a large meta-analysis of 140,254 individuals; prostatitis was obtained from the FinnGen consortium. The inverse variance weighted method was the main analysis method. MR-Egger, Cochran's Q, radial MR, and MR-PRESSO tests were used for sensitivity analysis.</p><p><strong>Results: </strong>Our results demonstrated that never eating sugar [odds ratio (OR), 0.30; 95% confidence interval (CI), 0.11-0.80; p = 0.02] and never eating eggs (OR, 0.52; 95% CI, 0.28-0.97; p = 0.04) reduced the risk of PCa; raw vegetable intake (OR, 2.27; 95% CI, 1.01-5.09; p < 0.05) and dried fruit intake (OR, 1.38; 95% CI, 1.02-1.87; p = 0.04) increased PCa risk. And a negative correlation existed between processed meat intake and prostatitis (OR, 0.27; 95% CI, 0.08-0.94; p = 0.04). After adjusting for smoking and drinking, never eating sugar was negatively correlated with PCa, while the raw vegetable intake was positively correlated with the risk of PCa.</p><p><strong>Conclusion: </strong>Our study found four different foods associated with PCa and one food intake associated with prostatitis. We recommend more high-quality studies to reassess the benefits of individual foods in PCa.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"339-348"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848932","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":"Flexible ureterorenoscopy vs. mini percutaneous nephrolithotomy for kidney stones in chronic kidney damage: a prospective study.","authors":"Nazım Furkan Günay, Mücahit Gelmiş, Çağlar Dizdaroğlu, Abdullah Esmeray, Ufuk Çağlar, Ömer Sarılar, Faruk Özgör","doi":"10.32604/cju.2025.072419","DOIUrl":"10.32604/cju.2025.072419","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic kidney disease (CKD) poses unique challenges in the management of renal stones, and high-quality evidence to guide treatment decisions is limited. This study aimed to compare the effects of flexible ureteroscopy (f-URS) and mini-percutaneous nephrolithotomy (m-PCNL) on perioperative outcomes and long-term renal function in patients with CKD and renal stones.</p><p><strong>Methods: </strong>This prospective randomized study included 60 CKD patients with renal stones measuring 1-4 cm. Participants were randomized into f-URS (n = 24) and m-PCNL (n = 36) groups. Baseline demographics, stone characteristics, and perioperative parameters were recorded. Stone-free rate (SFR) was defined as the absence of any residual fragments on postoperative computed tomography (CT) at 1 month. Renal function was assessed by estimated glomerular filtration rate (eGFR), serum creatinine, and CKD stage at baseline and 6 months. A post hoc exploratory subgroup analysis was performed for patients with 10-20 mm stones.</p><p><strong>Results: </strong>Stone-free rates were comparable between groups (79.2% vs. 86.1%, p > 0.05). f-URS was associated with shorter operative duration, reduced fluoroscopy time, lower hemoglobin drop, and shorter hospital stay (all p < 0.01). At 6 months, median renal function values were more favorable in the f-URS group, with higher median eGFR (44.0 vs. 51.5 mL/min, p = 0.042) and lower creatinine (1.6 vs. 1.4 mg/dL, p = 0.031), whereas the changes from baseline (ΔeGFR and Δcreatinine) did not show a statistically significant difference. In the exploratory 10-20 mm subgroup results were statistically in favor of f-URS, but these findings should not be generalized due to the small sample size and post hoc nature of the analysis.</p><p><strong>Conclusions: </strong>Both f-URS and m-PCNL achieved similar stone clearance in CKD patients. f-URS may offer advantages regarding perioperative safety and renal function preservation, but these observations require confirmation in larger studies with long-term follow-up. Treatment decisions in this high-risk population should be individualized.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"281-290"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848916","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":"Proximal/Distal ureteral diameter ratio as a predictor of spontaneous passage in <10 mm ureteral stones.","authors":"İbrahim Üntan, Nuh Aldemir","doi":"10.32604/cju.2026.076805","DOIUrl":"10.32604/cju.2026.076805","url":null,"abstract":"<p><strong>Background: </strong>Ureteral stones are a common cause of acute renal colic, and while most small stones pass spontaneously, reliable predictors of passage are needed to optimize patient selection for conservative management. This study aims to evaluate the role of radiologic, clinical and laboratory parameters-particularly the proximal/distal (P/D) ureteral diameter ratio-in predicting spontaneous passage of <10 mm ureteral stones.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 277 patients diagnosed with ureteral calculi <10 mm on non-contrast computed tomography between September 2022 and September 2025. Pregnant patients, solitary kidney cases, congenital anomalies, active urinary infection, and incomplete computed tomography (CT) data were excluded. Proximal and distal ureteral diameters were measured 1 cm above and below the stone on axial CT images, and their ratio (P/D ratio) was calculated. Stones located at the ureterovesical or ureteropelvic junction were excluded from ratio analysis due to anatomic constraints. Spontaneous passage within 4 weeks was confirmed by follow-up ultrasonography in all patients. Patients were grouped into passage (n = 204) and no-passage (n = 73). Mann-Whitney U and chi-square tests were used for group comparisons. Predictive performance was assessed by receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>The spontaneous passage rate was 73.6%. Age, sex, and body mass index did not differ significantly between groups (p ≥ 0.05). Stone size (p < 0.001), location (p = 0.003), CT Hounsfield Unit (HU) (p < 0.001), and P/D ureteral diameter ratio (p < 0.001) were significantly associated with passage. Distal and ≤5 mm stones demonstrated markedly higher spontaneous passage rates. Median HU was lower in the passage group (487.00 [348.75-707.00]) than in the no-passage group (648.00 [467.00-846.00]). The P/D ratio was significantly lower in the passage group (2.90 [2.21-3.50]) compared with the no-passage group (4.20 [3.05-5.33]). Alpha-blocker use was not associated with passage (p = 0.232). ROC analysis demonstrated that stone size (area under the curve [AUC] 0.773) and P/D ratio (AUC 0.757) were the strongest predictors, outperforming HU (AUC 0.645) and location (AUC 0.617).</p><p><strong>Conclusions: </strong>Stone size, location, HU value, and the proximal/distal ureteral diameter ratio are significant markers associated with spontaneous passage of <10 mm ureteral stones. Lower HU values, distal location, smaller stone size, and a reduced P/D ratio favor spontaneous passage. The P/D ratio, a simple and practical CT-derived measurement, showed superior discriminative ability compared with HU and may assist clinicians in selecting appropriate candidates for conservative management.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"239-248"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848908","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":"Robot-assisted partial nephrectomy during simultaneous extracorporeal membrane oxygenation and impella®in a candidate for left ventricular assist device as a bridge for cardiac transplant: a case report.","authors":"Francesco Cianflone, Giuseppe Ottone Cirulli, Alessio Villano, Mohammad Eisa Ali, Mirko Belliato, Roberto Veronesi, Germana Bichisao, Carlo Marchetti, Simona Secondino, Paolo Pedrazzoli, Stefano Pelenghi, Carlo Pellegrini, Andrea Ringressi, Richard Naspro","doi":"10.32604/cju.2025.073002","DOIUrl":"10.32604/cju.2025.073002","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted partial nephrectomy (RAPN) is standard for cT1 renal masses, but its feasibility in patients on temporary mechanical circulatory support is poorly documented. We report RAPN performed while a patient was simultaneously supported with venous-arterial extracorporeal membrane oxygenation (VA ECMO) and Impella®, as part of a staged plan for left ventricular assist device (LVAD) implantation and eventual heart transplantation.</p><p><strong>Case presentation: </strong>A 51-year-old man presented with ST-elevation myocardial infarction complicated by cardiogenic shock requiring percutaneous coronary intervention with stenting, dual antiplatelet therapy, and combined VA ECMO-Impella® support. During workup for cardiac transplant, computed tomography (CT) staging revealed a 16-mm left renal mass suspicious for renal cell carcinoma. A multidisciplinary team prioritized definitive treatment to preserve transplant eligibility and elected RAPN under systemic heparinization alongside aspirin continuation (cangrelor briefly withheld). Therefore, RAPN was performed with 9 min of warm ischemia. The intraoperative course was hemodynamically stable. On postoperative day (POD) 4, late arterial bleeding from the resection bed was controlled by selective angioembolization. On POD 7, a durable LVAD was implanted as a bridge to heart transplantation. Final pathology showed pT1a, G2, R0 clear cell renal cell carcinoma. At 6 months, contrast-enhanced CT showed no recurrence and no major cardiovascular complications.</p><p><strong>Conclusions: </strong>RAPN during simultaneous ECMO and Impella® support is technically feasible with meticulous anticoagulation management, interventional radiology standby, and coordinated planning. This approach enables oncologic control while preserving a trajectory to transplant candidacy.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"459-470"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848861","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":"Analysis of risk factors for MRI-invisible prostate cancer-the significance of AGGF1 immunohistochemical detection and PSAD.","authors":"Jingcheng Lyu, Ruiyu Yue, Ye Tian, Boyu Yang","doi":"10.32604/cju.2026.074814","DOIUrl":"10.32604/cju.2026.074814","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with a multi-parameter magnetic resonance imaging (mpMRI) prostate imaging report and data system (PI-RADS) score ≤ 3, but with clinically significant prostate cancer (CSPCa) detected by biopsy, are termed MRI-Invisible prostate cancer (MRI(-)PCa). This study aims to explore risk factors for MRI(-)PCa and identify immunohistochemical indicators with predictive significance.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 376 patients with PI-RADS score ≤ 3 who underwent 24-needle systematic prostate biopsy at Beijing Friendship Hospital, Capital Medical University (January 2015 to October 2025). Clinical data, imaging data, and Angiogenic factor with G and FHA domain 1 (AGGF1) immunohistochemical results were collected. Patients were grouped into CSPCa (n = 102) and non-CSPCa (n = 274). t-tests, rank sum tests, and χ2 tests were used for univariate analysis, followed by multivariate Logistic regression to determine independent risk factors. Receiver Operating Characteristic (ROC) curves were drawn. Subgroup analyses were conducted based on prostate-specific antigen (PSA) status and PI-RADS score using the same statistical methods. Moreover, we also used the Kruskal-Wallis test to compare the differences in AGGF1 expression percentages across different Gleason score groups according to ISUP in CSPCa patients.</p><p><strong>Results: </strong>Multivariate Logistic regression analysis showed that prostate-specific antigen density (PSAD) [OR: 0.971, 95%CI: 0.952, 0.991] and high expression of AGGF1 [OR: 1.065, 95%CI: 1.022, 1.109] were independent risk factors for MRI(-)PCa (p < 0.05). Meanwhile, when the PSAD of the patient is more than 0.25 ng/mL/cm3, it is necessary to be more suspicious that the patient may have prostate cancer (p < 0.05), and an AGGF1 immunohistochemical analysis should be conducted after the biopsy. In the PSA-negative subgroup, only high AGGF1 expression was an independent risk factor (p < 0.05). In the PSA-positive subgroup, PSAD [OR: 0.500, 95%CI: 0.279, 0.895] and AGGF1 [OR: 1.064, 95%CI: 1.037, 1.092] results were independent risk factors (p < 0.05). In subgroup analyses for PI-RADS 1-2 and PI-RADS 3, both PSAD and AGGF1 were accurate predictors of CSPCa (p < 0.05). Among all CSPCa patients, in the Gleason score 3 + 3 group, the average AGGF1 expression percentage of the patients was 48.60% ± 11.03%, which was significantly lower than that of the Gleason score 4 + 3 group (61.00% ± 6.12%) and the Gleason score 4 + 4 group (71.01% ± 4.46%), and the differences were statistically significant (p < 0.001).</p><p><strong>Conclusions: </strong>For patients with a PI-RADS score ≤ 3, attention should be paid to PSAD before biopsy, especially for those patients with PSAD > 0.25 ng/mL/cm3, not just PSA levels. After biopsy, AGGF1 immunohistochemical staining can be supplemented to help determine the risk and the malignancy of CSPCa.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"361-375"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848882","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":"Urodynamic de-obstruction and symptom improvement after thulium laser vaporization (ThuVAP): evidence from a prospective paired study.","authors":"Simone Tammaro, Francesco Di Fiore, Felice Crocetto, Celeste Manfredi, Claudia Collà Ruvolo, Gianluigi Califano, Biagio Barone, Davide Arcaniolo, Lorenzo Spirito, Francesco Paolo Calace, Pasquale Reccia, Ferdinando Fusco, Marco De Sio, Raffaele Balsamo","doi":"10.32604/cju.2025.072617","DOIUrl":"10.32604/cju.2025.072617","url":null,"abstract":"<p><strong>Background: </strong>Thulium laser vaporization of the prostate (ThuVAP) is an established treatment for benign prostatic obstruction, but its impact on urodynamic parameters remains poorly defined. This study aimed to quantify the de-obstructive efficacy of ThuVAP through pre- and postoperative urodynamic comparisons and to assess the relationship between urodynamic improvement and symptom relief.</p><p><strong>Methods: </strong>In a prospective single-center cohort (June 2022-June 2024), men with urodynamically confirmed obstruction underwent standardized ThuVAP with a 200-W thulium:YAG system. Baseline and 6-month invasive urodynamics and 12-month clinical follow-up were performed. The primary endpoint was the change in the bladder outlet obstruction index (BOOI); secondary endpoints included Qmax, postvoid residual volume (PVR), bladder voiding efficiency (BVE), detrusor pressures, and International Prostate Symptom Score (IPSS).</p><p><strong>Results: </strong>Sixty-four patients (mean age 67 years; prostate volume 52 mL) were analyzed. BOOI decreased from 55.9 ± 17.2 to 21.3 ± 11.2 (p < 0.001), with obstructed cases dropping from 79.7% to 7.8%. Schäfer grade fell from 3.6 to 0.3 (p < 0.001). Detrusor pressure halved, Qmax rose from 7.9 to 20.8 mL/s, PVR declined from 121 to 22 mL, and BVE improved from 64% to 94% (all p < 0.001). Low compliance and involuntary detrusor contractions (IDC) decreased notably. IPSS improved from 26.2 to 3.4 (p < 0.001) and correlated with the magnitude of urodynamic de-obstruction.</p><p><strong>Conclusions: </strong>ThuVAP provides substantial, objectively verified relief of bladder outlet obstruction with consistent improvements in voiding efficiency and symptoms. The correlation between urodynamic and clinical outcomes underscores the procedure's efficacy and the utility of urodynamics in documenting therapeutic benefit.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"249-259"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848914","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":"Genetic evidence against a causal relationship between myocardial infarction and urological malignancies.","authors":"Wei Zhang, Xixi Peng","doi":"10.32604/cju.2026.072565","DOIUrl":"10.32604/cju.2026.072565","url":null,"abstract":"<p><strong>Background: </strong>Observational studies have suggested potential associations between myocardial infarction (MI) and cancer risk, but the causal nature of these relationships remains unclear due to confounding factors and reverse causation. We aimed to investigate the bidirectional causal relationships between MI and urinary system cancers using genetic instruments.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization (MR) analysis using summary statistics from large-scale genome-wide association studies. Genetic variants associated with MI were used as instrumental variables (n = 19 SNPs for prostate cancer [PCa] and malignant neoplasm of kidney [MRN], n = 6 SNPs for bladder cancer, n = 21 SNPs for bladder cancer [BCa] validation). We examined the causal effects of MI on PCa, BCa, and MRN risk, as well as reverse causation. Multiple MR methods were employed, including inverse variance weighted (IVW), MR-Egger, weighted median, and weighted mode approaches. Both discovery and validation datasets were analyzed to ensure robustness.</p><p><strong>Results: </strong>Forward MR analysis revealed no significant causal effect of MI on urinary system cancer risk across all examined malignancies. For PCa, the odds ratios (ORs) ranged from 0.964 to 1.007 across different methods and datasets (all p > 0.05). Similarly, MI showed no causal association with BCa risk (OR = 1.000, 95% CI: 0.999-1.002 in discovery cohort; OR = 1.000, 95% CI: 1.000-1.001 in validation cohort) or MRN risk (OR = 0.989-1.060 across methods in discovery cohort). Reverse MR analysis demonstrated no significant causal effects of PCa or kidney malignancy on MI risk, with ORs ranging from 0.250 to 1.200 (all p > 0.05). Sensitivity analyses confirmed the absence of pleiotropy and heterogeneity.</p><p><strong>Conclusion: </strong>Our genetic evidence does not support causal relationships between MI and urinary system cancers in either direction. The observed associations in epidemiological studies may be attributed to shared risk factors, treatment effects, or residual confounding rather than direct causal mechanisms. These findings have important implications for cancer surveillance strategies in MI patients and understanding cardio-oncology interactions.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"387-401"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848937","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":"Electroacupuncture for sperm improvement in varicocele: a case report.","authors":"Ida Nurwati, Uki Retno Budihastuti, Bhisma Murti, Teguh Prakosa, Metanolia Sukmawati","doi":"10.32604/cju.2025.068548","DOIUrl":"10.32604/cju.2025.068548","url":null,"abstract":"<p><strong>Background: </strong>Varicocele is a common cause of male infertility, often associated with impaired sperm quality, hormonal imbalance, and increased DNA fragmentation. Electroacupuncture (EA) has been proposed as an adjunct therapy to improve reproductive parameters, but clinical evidence remains limited.</p><p><strong>Case description: </strong>This case report describes a 38-year-old male with a varicocele treated at Dr. Moewardi General Hospital, Indonesia. The patient underwent 16 sessions of EA therapy. Sperm parameters and serum testosterone levels were measured before and after treatment. Following EA, sperm concentration improved from 5.2 to 6.7 × 106/mL, motility increased from 43% to 60%, and normal morphology rose from 1% to 3%. Testosterone levels increased from 329.6 to 596.2 ng/dL, while the DNA Fragmentation Index (DFI) decreased from 40% to 19.6%.</p><p><strong>Conclusions: </strong>This case suggests that EA therapy may improve sperm quality, enhance testosterone levels, and reduce DFI in a patient with varicocele. However, further controlled studies are needed to confirm these findings due to the limitations of a single case report.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"489-495"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848894","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}