Advances in Urology最新文献

{"title":"Drug-Coated Balloon (Optilume^®) Shows a Low Reintervention Rate in Patients With Bulbar Urethral Strictures: Real-World Data From Two German Centers.","authors":"Juan Jose Menendez-Suarez, Georgi Tosev, Hendrik Borgmann, Johannes Salem, Timur Kuru","doi":"10.1155/aiu/8510976","DOIUrl":"https://doi.org/10.1155/aiu/8510976","url":null,"abstract":"<p><strong>Background: </strong>Bulbar urethral strictures are a common cause of lower urinary tract symptoms (LUTSs) in men and frequently recur after standard endoscopic treatments. There is growing interest in identifying less invasive techniques that provide durable outcomes compared to conventional endoscopic methods. Optilume has shown favorable outcomes in prospective trials, but real-world evidence, especially including treatment-naïve patients, remains limited.</p><p><strong>Methods: </strong>We performed a retrospective study in two German urology practices, including 40 men with symptomatic bulbar urethral strictures. Symptoms were assessed using the International Prostate Symptom Score (IPSS) and IPSS-derived quality-of-life (QoL) score at baseline and at follow-up. The primary endpoints were changes in IPSS and QoL; secondary endpoints included reintervention and safety. Nonparametric paired testing (Wilcoxon) and correlation analysis (Pearson) were applied.</p><p><strong>Results: </strong>Median follow-up was 29.5 months. IPSS improved from a median of 19.5 (2-35) to 6.0 (0-26), and QoL improved from 5.0 (0-6) to 1.0 (0-5) (<i>p</i> < 0.000001). The median absolute change was ΔIPSS -10.5 overall; ΔIPSS was -16.5 in treatment-naïve patients and -9.5 in previously treated patients. Median ΔQoL was -4.0 overall (-3.5 treatment-naïve; -4.0 previously treated). One patient (2.5%) was scheduled for reintervention due to subjective dissatisfaction despite IPSS improvement. Treatment-naïve patients showed a trend toward better outcomes.</p><p><strong>Conclusions: </strong>Optilume demonstrated excellent mid-term outcomes (median follow-up: 29.5 months) in the treatment of bulbar urethral strictures, with significant improvements in symptom burden and QoL and a low reintervention rate (2.5%) in a real-world two-center cohort with a nonsignificant trend toward greater symptomatic improvement in treatment-naïve individuals. These findings support Optilume as a viable minimally invasive option. Larger prospective studies incorporating stricture-specific patient-reported outcome measures and comparative designs are needed to confirm long-term effectiveness, cost considerations, and optimal patient selection.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"8510976"},"PeriodicalIF":2.3,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive 90-Day Morbidity Assessment Following Robot-Assisted Radical Cystectomy With Intracorporeal Diversion.","authors":"Anas Elyan, Laura Wimmer, Jan Ebbing, Helge H Seifert, Abolfazl Hosseini, Ashkan Mortezavi","doi":"10.1155/aiu/5585494","DOIUrl":"https://doi.org/10.1155/aiu/5585494","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate perioperative morbidity following robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) during the transition from open surgery at a single academic center, and to provide detailed complication profiles to guide surgical teams and patient counseling.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 111 consecutive patients undergoing iRARC between 2017 and 2023. Perioperative outcomes and complications were assessed at 30 and 90 days, using the Clavien-Dindo (CD) classification. Complications were further categorized by etiology and severity. Detailed incidence rates and management strategies were recorded per patient.</p><p><strong>Results: </strong>A total of 163 complications occurred within 90 days, with 129 (79%) recorded within 30 days. Early complications were predominantly low-grade (<i>n</i> = 96, 74%), while 33 (26%) were high-grade. Systemic complications 108 (84%) outnumbered primary surgical events 21 (16%). Among early high-grade complications, cardiovascular and respiratory events were the most common (<i>n</i> = 9, 27%), followed by infectious (<i>n</i> = 7, 21%) and genitourinary complications (<i>n</i> = 7, 21%). Incidence rates for events were calculated on a per-patient basis: acute coronary syndrome 1.2%, pneumonia 2.7%, arrhythmias 2.7%, thrombosis 1.8%, pulmonary embolism 0.9%, insufficiency of the ileal anastomosis 0.9%, urinary tract infections 32.4%, and infected lymphoceles 8.1%. Genitourinary complications, including ureteral strictures (6.3%) and urinary leakage (3.6%), required frequent endourological interventions. Despite minimally invasive surgery and strict ERAS protocol implementation, paralytic ileus occurred in 19.8% of patients but was managed conservatively in all cases. Thirty-four additional complications occurred between days 30 and 90, including 16 high-grade events. The 90-day mortality rate was 1.8%. In the multivariable analysis, no independent predictors of high-grade complications were identified. Variables including BMI, clinical stage ≥ cT2, age, sex, and neoadjuvant chemotherapy showed no significant association (all <i>p</i> ≥ 0.20).</p><p><strong>Conclusion: </strong>iRARC is feasible and associated with an acceptable safety profile during the learning curve. Most complications were systemic and not directly related to the surgical technique, underscoring the need for multidisciplinary perioperative management. Detailed incidence data of specific complications provide valuable insights for realistic patient counseling and heightened awareness among care teams.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"5585494"},"PeriodicalIF":2.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12746349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Look at HPV Vaccine Acceptance and Associated Factors Among Male University Students in Lebanon.","authors":"Ziad Koberssy, Joey El Khoury, Rami Halabi, Joviane Daher, Nadine Saleh, Raghid El Khoury, Charbel El Hachem","doi":"10.1155/aiu/9303212","DOIUrl":"https://doi.org/10.1155/aiu/9303212","url":null,"abstract":"<p><strong>Background and aims: </strong>The human papillomavirus (HPV) is the leading sexually transmitted infection (STI) worldwide. Oncogenic HPV serotypes lead to various anogenital cancers in men. Societal changes in previously conservative regions like Lebanon have increased STI risks, particularly among university students. While several studies have focused on HPV prevalence in Lebanese females, data on males remain scarce. Men HPV vaccination is crucial for the prevention of HPV-related cancers in both sexes. This study aims to assess vaccination prevalence among Lebanese male university students, identify influencing factors, and evaluate their HPV and its vaccine knowledge.</p><p><strong>Methods: </strong>This is a cross-sectional analytical study surveying male students at Lebanese universities ranging from 17 to 30 years. Data were collected using closed-ended questions distributed through an online platform. We compared vaccination rates with different variables using a bivariate analysis. The chi-squared test was utilized for categorical variables, while Fisher's exact test was employed for nonparametric evaluations of categorical data. For continuous variables, parametric and nonparametric analyses, the independent sample <i>t</i>-test, and the Mann-Whitney <i>U</i> test, respectively, are used. Throughout these investigations, statistical significance was set at a <i>p</i>-value ≤ 0.05 (95% confidence interval).</p><p><strong>Results: </strong>324 individuals completed the study. HPV vaccination prevalence was 5.2% (<i>n</i> = 17). In people not taking the HPV vaccine, limited knowledge of HPV (34.57%) and its vaccine (25.62%) as well as the lack of physician recommendation (31.17%) were the main barriers. Compared to their nonvaccinated peers (3.27 over 13), vaccinated participants (6 over 13) showed an increased HPV vaccination knowledge index (<i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>The study revealed diminished HPV vaccination rates among male university students in Lebanon, primarily attributed to inadequate knowledge and low physician recommendations. Targeted awareness campaigns and incorporating HPV vaccination into the national vaccination card are recommended to promote vaccination rates.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"9303212"},"PeriodicalIF":2.3,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of IncontiLase Er:YAG Laser Treatment on the Quality of Life of Women With Stress Urinary Incontinence.","authors":"Vidya Pancholia, Tamanna Pancholia, Iva Talaber, Zdenko Vižintin","doi":"10.1155/aiu/1255593","DOIUrl":"https://doi.org/10.1155/aiu/1255593","url":null,"abstract":"<p><strong>Objective: </strong>Assessment of health-related quality of life (QoL) is particularly crucial in urinary incontinence because this condition significantly affects patients' social, psychological, physical, emotional, and economic wellbeing. The objective of this service evaluation was to assess various QoL outcomes in patients with stress urinary incontinence (SUI) before and after treatment with a nonablative Er:YAG laser.</p><p><strong>Methods: </strong>Upon receiving SUI laser treatment (IncontiLase) at our clinic, 49 patients subsequently provided follow-up assessments of health-related QoL outcome measures at two time points (2-month FU (FU1) and 9-month FU (FU2)).</p><p><strong>Results: </strong>Prior to treatment, patients were strongly bothered by their SUI symptoms. Two months after treatment, all the patients reported significant improvements of SUI symptoms and SUI-related QoL, which continued to improve with time. According to the QoL scores, patients did not consider their SUI symptoms bothersome enough to seek further medical care after laser treatment, even after a period of 9 months.</p><p><strong>Conclusions: </strong>Nonablative Er:YAG laser treatment was associated with substantial, clinically meaningful improvements in patient-reported SUI-related QoL in a real-world clinical setting. This service evaluation supports the use of Er:YAG laser treatment in clinical practice, although the study design limits the strength of conclusions regarding its effectiveness.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"1255593"},"PeriodicalIF":2.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engineering the Future of Bladder Repair: Can Biocompatible 3D-Printed Scaffolds Serve as a Novel Alternative to Intestinal Segments for the Treatment of Bladder Exstrophy?","authors":"M Forooghi, A Askari, M Haghdel, A G Haghighi, M H Anbardar, A H Hassani, H Foroutan, A S Aloudal, Sh Yousufzai","doi":"10.1155/aiu/9437696","DOIUrl":"10.1155/aiu/9437696","url":null,"abstract":"<p><p><b>Background:</b> Bladder reconstruction traditionally involves intestinal segments, which, despite their effectiveness, carry significant risks such as metabolic disturbances and infection. Safer, synthetic alternatives are needed. We evaluated a novel 3D-printed multilayered bladder scaffold combining polylactic acid (PLA), thermoplastic polyurethane (TPU), and polyvinyl alcohol (PVA) in a rabbit model. <b>Methods:</b> Anatomically tailored scaffolds were designed using computer-aided design (CAD) and fabricated under good manufacturing practice (GMP) conditions. Mechanical integrity was assessed after 60 days of incubation in simulated bladder media, including measurements of modulus of elasticity, tensile strength, elongation, and shape recovery. Acid/alkaline resistance was tested for chemical stability. For in vivo analysis, four rabbits underwent bladder augmentation with a 1 × 1 cm scaffold-augmented defect. Postoperative outcomes were monitored for 60 days, followed by histopathological evaluation. <b>Results:</b> After incubation, the scaffolds retained mechanical strength (modulus: 1.2 ± 0.3 GPa; tensile strength: 18.5 ± 2.1 MPa) with minimal elongation reduction (25% vs. 28% unused). Chemical testing confirmed structural stability and full shape recovery. In vivo, all rabbits survived without urinary leakage. Mild intra-abdominal adhesions and universal cystolithiasis were noted. Histology showed complete urothelial reepithelialization and mild-to-moderate submucosal fibrosis with chronic inflammation but no necrosis or acute inflammation. Compared to biological scaffolds, the synthetic construct showed reduced mortality and comparable inflammation, though with increased stone formation. <b>Conclusion:</b> This 3D-printed scaffold demonstrates promising biocompatibility, mechanical durability, and integration in bladder repair. While early results are encouraging, further studies with larger sample sizes and longer follow-up are needed to address limitations such as cystolithiasis risk.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"9437696"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Prostate-Specific Antigen Failure as a Unique Prognosticator of Overall Survival in Biochemically Recurrent Prostate Cancer Patients Undergoing Radical Prostatectomy.","authors":"Tomoyuki Shimabukuro, Takanori Tokunaga, Kosuke Shimizu, Nakanori Fujii, Keita Kobayashi, Toshiya Hiroyoshi, Hiroshi Hirata, Koji Shiraishi","doi":"10.1155/aiu/2961319","DOIUrl":"10.1155/aiu/2961319","url":null,"abstract":"<p><p><b>Background:</b> In biochemically recurrent prostate cancer (BRPC), no definitive independent prognostic factors were reported. This study aimed to identify the factors impacting overall survival (OS) in patients with BRPC after radical prostatectomy (RP). <b>Methods:</b> Among 610 consecutive patients who underwent RP between January 2000 and December 2019, with follow-up through December 2024, 152 (25%) patients who developed BRPC were analyzed. The primary endpoint was to identify an independent prognosticator of OS, while the secondary endpoint was to investigate clinical and tumor characteristics in BRPC patients. <b>Results:</b> The median age of the cohort was 67 years. Of the BRPC patients, 37 (24.4%) were managed with observation alone, 80 (52.6%) underwent external beam radiation therapy with or followed by androgen deprivation therapy (ADT), and 35 (23.0%) received ADT alone. During follow-up, two cases of local recurrence and nine cases of distant metastases were observed, with seven patients (1.2%) progressing to castration-resistant prostate cancer. Over a median follow-up of 118 months, 21 all-cause and 5 cancer-specific deaths were recorded. Multivariable analysis identified time to biochemical recurrence (TTBR) as the sole independent significant prognostic factor for OS (hazard ratio: 0.956, 95% confidence interval: 0.916-0.997, <i>p</i>=0.036). Kaplan-Meier survival curves, using a TTBR cutoff of 12 months, revealed significant differences in OS between the shorter and longer TTBR cohorts. <b>Conclusions:</b> This long-term retrospective study demonstrates that TTBR may serve as a unique independent prognostic factor for OS in BRPC patients. A TTBR of ≤ 12 months was significantly associated with worse OS, irrespective of clinicopathological risk features.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"2961319"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uroflowmetry Parameters in Patients Undergoing Artificial Urinary Sphincter Implantation.","authors":"Hisanori Taniguchi, Sho Kiyota, Nae Takizawa, Hidefumi Kinoshita","doi":"10.1155/aiu/9995075","DOIUrl":"10.1155/aiu/9995075","url":null,"abstract":"<p><p><b>Objectives:</b> The study aims to determine the uroflowmetry parameters of patients undergoing artificial urinary sphincter (AUS) implantation. Hence, uroflowmetry results pre- and post-AUS implantation and differences according to patient background were evaluated. <b>Methods:</b>Thirty-five patients who underwent primary AUS implantation for severe stress urinary incontinence due to radical prostatectomy were enrolled. All patients underwent uroflowmetry tests before and 1, 3, 6, and 12 months after AUS device activation. The patients reported outcomes using validated questionnaires: the King's Health Questionnaire (KHQ), the International Prostate Symptom Score (IPSS), and the quality of life (QOL) score. <b>Results:</b> The mean patient age was 72.8 ± 5.4 years. The mean maximum flow rate (<i>Q</i> _max) value pre-AUS implantation (20.4 ± 11.3 mL/s) was significantly higher at 1-month post-AUS implantation and maintained at 12 months (26.0 ± 14.7 mL/s; <i>p</i>=0.011). KHQ, IPSS, and QOL scores were significantly improved after AUS implantation. <i>Q</i> _max, and voiding volume was significantly higher in patients aged < 73 years compared to those aged ≥ 73 years. <b>Conclusion:</b> Uroflowmetry parameters were improved after AUS implantation and maintained for at least 12 months. Not only subjective outcomes but also objective outcomes of uroflowmetry parameters significantly improved after AUS implantation. This is the first report assessing uroflowmetry outcomes after AUS implantation.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"9995075"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intraoperative Local Administration of Tranexamic Acid on Hemorrhage in Patients Undergoing Open Prostatectomy: A Double-Blinded Randomized Parallel-Group Trial.","authors":"Mahdi Hemmati Ghavshough, Zahra Shirinzadeh, Mansour Alizadeh, Mohammad Sadri, Saman Farshid","doi":"10.1155/aiu/9294177","DOIUrl":"10.1155/aiu/9294177","url":null,"abstract":"<p><p><b>Background and Objective:</b> Benign prostatic hyperplasia (BPH) often necessitates surgical treatment, with open prostatectomy remaining a standard approach. However, this procedure carries a significant risk of intraoperative and postoperative bleeding, often requiring blood transfusions. Tranexamic acid (TXA), an antifibrinolytic agent, has shown potential in reducing surgical blood loss. This study aims to evaluate the effect of intraoperative local administration of TXA on perioperative blood loss in patients undergoing open prostatectomy for BPH. <b>Methods:</b> In this double-blind randomized controlled trial, 140 patients with BPH were assigned to either a TXA group or control group. In the intervention group, 1 g of TXA was diluted in 100 mL of normal saline and injected into the prostatic fossa during surgery, followed by three additional postoperative doses. The primary outcome was total perioperative blood loss. Secondary outcomes included changes in hemoglobin, hematocrit, platelet count, transfusion requirement, and length of hospital stay. Baseline differences, including a significant age gap between the groups (mean age: TXA group 60.70 ± 7.44 years vs. control group 70.50 ± 6.68 years), were statistically adjusted during analysis. <b>Results:</b> Perioperative blood loss was significantly lower in the TXA group (116.65 ± 43.23 mL) compared to the control group (210.27 ± 87.94 mL, <i>p</i> value = 0.001). The mean hemoglobin drop was also significantly reduced in the TXA group at both 24 and 48 h postoperatively. Fewer patients in the TXA group required blood transfusion (2.85%) compared to the control group (10%, <i>p</i> value = 0.03). No major adverse events directly attributed to TXA were identified, although one patient in the TXA group developed a pulmonary embolism. <b>Conclusion:</b> Intraoperative local administration of TXA significantly reduces perioperative blood loss and the need for blood transfusion in patients undergoing open prostatectomy. TXA appears to be a safe and effective strategy for minimizing surgical bleeding in this setting. <b>Trial Registration:</b> Iranian Registry of Clinical Trials: IRCT20180625040232N8.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"9294177"},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteral Occlusion: Device Strategies, Approaches, and Results.","authors":"Benjamin Treutler, Sahana Kumar, Christopher Shallal, Aryaman Gupta, Sanjana Kumar, Nicholas Zhang, Sean Healy, Jayaram Mandavilli, Nehali Gupta, Elizabeth A Logsdon, Jordan Shuff, E James Wright, Clifford R Weiss","doi":"10.1155/aiu/7843401","DOIUrl":"10.1155/aiu/7843401","url":null,"abstract":"<p><p>Genitourinary tract injuries can occur in the urinary tract or reproductive system as a result of trauma-related pelvic fractures, iatrogenic lacerations or ligations, and radiation therapy for reproductive or digestive malignancies. Although surgical reintervention is possible for large urinary tract injuries, a key component for healing smaller injuries is the ability to divert urine from the injury site to prevent urine-wound contact. This enables the injury to heal prior to reintervention and can eliminate the need for a secondary procedure, reducing the potential for complications. This type of urinary diversion is required by 140,000 patients in the United States annually, leading to the development of several devices to divert urine. The current standard of care includes minimally invasive procedures, such as placement of a catheter, double-J stent, or nephroureteral stent, but such measures often do not maintain sufficient dryness to enable wound healing. Based on a review of the literature, we have determined that successful devices need to prevent 100% of the anterograde urine flow, resist migration down the ureter because of peristalsis, and prevent urothelium growth over the device to promote wound healing without causing complications or necessitating reintervention. We also evaluated these devices according to the robustness of the study populations and designs in which they are reported. Some of the more successful devices include detachable, semicompliant balloons, platinum coils, and ureteral clips. Here, we present a narrative review of temporary and permanent ureteral occlusion devices and evaluate their potential for supporting wound healing. We also explore metrics by which to compare and select appropriate devices for urinary diversion.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"7843401"},"PeriodicalIF":1.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical Outcomes of Radical Prostatectomy Versus Image-Guided and Intensity-Modulated Radiation Therapy for Prostate Cancer: A Retrospective and Comparative Study.","authors":"Tomoyuki Shimabukuro, Tanaka Hidekazu, Tanabe Masahiro, Takanori Tokunaga, Kosuke Shimizu, Nakanori Fujii, Keita Kobayashi, Hiroshi Hirata, Koji Shiraishi","doi":"10.1155/aiu/6412793","DOIUrl":"10.1155/aiu/6412793","url":null,"abstract":"<p><p><b>Background and Objective:</b> The optimal definitive treatment for localized prostate cancer (PCa)-radical prostatectomy (RP) or intensity-modulated radiation therapy with image guidance (IMRTG) remains controversial. This study compares the long-term clinical outcomes of RP and IMRTG in patients with PCa. <b>Methods:</b> We retrospectively analyzed 884 consecutive PCa patients over 25 years. Among them, 610 (69%) underwent RP, while 274 (31%) received IMRTG starting in 2011. The primary objective was to comprehensively assess both treatment modalities. <b>Results:</b> The median age was 68 years in the RP cohort and 73 years in the IMRTG cohort. The median operation time for RP was 4.11 h, with nerve-sparing procedures performed in 45% of cases. Median blood loss was 310 mL, the urinary incontinence rate was 13%, and the median hospital stay was 14 days. In the RP cohort, 46 complications (28%) occurred, including a Grade 4 rectal injury and a Grade 4 wound insufficiency. In the IMRTG cohort, over 80% of patients experienced radiation-induced urological complications, with 11% reporting Grade 2 adverse effects. During a median follow-up of 98 months, there were 79 all-cause deaths and 7 PCa-specific deaths. The 15-year overall survival (OS) rates were 80.9% for RP and 58.3% for IMRTG; however, this difference was not significant in the multivariate analysis, likely due to a higher proportion of high-risk disease in the IMRTG cohort. Approximately 45% of all deaths were attributed to malignant tumors. <b>Conclusions:</b> This long-term retrospective study provides valuable insights into the comparative effects of RP and IMRTG on OS in PCa patients. Both treatments are associated with distinct adverse events, complications, and impacts on urinary continence and sexual function, highlighting the importance of individualized clinical decision-making.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"6412793"},"PeriodicalIF":1.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}