BMC Urology最新文献

{"title":"Outcomes of radical cystectomy in a resource-limited setting: a pilot study.","authors":"Sami Mahjoub Taha, Abubaker Abdelhi Abdallah, Yassin Mohammed Osman, Mussab Mahjoub Taha, Moawia Mohammed Ali Elhassan, Mohammed El Imam Mohammed Ahmed","doi":"10.1186/s12894-025-01713-x","DOIUrl":"10.1186/s12894-025-01713-x","url":null,"abstract":"<p><strong>Background: </strong>Radical cystectomy is a cornerstone treatment for muscle-invasive bladder cancer, but its implementation in resource-limited settings is challenged by limited access to trained professionals and inadequate healthcare infrastructure. This pilot study aims to analyze perioperative complications and mortality associated with radical cystectomy and urinary diversion at Gezira Hospital for Renal Diseases and Surgery (GHRDS) in Sudan. These findings reflect the outcomes of an in-country training program established by the Society of International Urology (SIU) to address surgical capacity gaps in resource-limited settings.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patient who underwent radical cystectomy with ileal conduit urinary diversion between January 2015 and December 2019. Data were collected from medical records, including demographic details, perioperative complications classified by the modified Clavien-Dindo system, and histopathological findings.</p><p><strong>Results: </strong>A total of 30 patients were included in the study. The median age was 65 years, and 77% were male. The majority of patients (76%) had transitional cell carcinoma, followed by squamous cell carcinoma (17%) and adenocarcinoma (7%). The clinical stage at presentation were T1 N0 M0 (23%) and T2 N0 M0 (77%). A total of 32 complications were observed, with 91% classified as low-grade. Infectious complications were the most common (50%), followed by gastrointestinal and respiratory issues. Severe complications occurred in 13% of cases, and in-hospital mortality was 3%.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of performing radical cystectomy in a resource-constrained environment, supported by a collaborative training program involving international expertise and local participants. While outcomes were encouraging, key areas for improvement include infection control, critical care capacity, and early detection of bladder cancer. These findings underscore the importance of sustainable in-service training programs in building surgical capacity in resource-limited settings. Future research should focus on long-term outcomes and strategies to reduce complications.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"31"},"PeriodicalIF":1.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-grade eosinophilic renal tumor/eosinophilic vacuolar renal tumor: a case report and literature review.","authors":"Yong Ou, Shangqing Ren, Fang Zhou, Zhengjun Chen, Qian Lv, Yu Nie, Dong Wang, Shida Fan","doi":"10.1186/s12894-025-01709-7","DOIUrl":"10.1186/s12894-025-01709-7","url":null,"abstract":"<p><strong>Introduction: </strong>Renal oncocytoma (RO) is an uncommon benign neoplasm of the kidney, while eosinophilic vacuolated tumor (EVT) represents a distinct subtype of renal oncocytoma characterized by specific morphological features. EVT is a rare eosinophilic renal neoplasm distinguished by its unique morphological, immunophenotypic, and molecular genetic attributes. Its biological behavior is generally indolent, and it is associated with a favorable prognosis.</p><p><strong>Case report: </strong>This case report provides a comprehensive account of a 52-year-old female patient who presented to the hospital for a medical evaluation, revealing that her left kidney had been occupying space for over one month. Following an abdominal enhanced CT scan, a diagnosis of renal clear cell carcinoma was suspected, leading to the decision to perform a \"robot-assisted laparoscopic partial left nephrectomy.\" During the surgical procedure, a mass measuring approximately 3.8 × 3.5 cm was identified adjacent to the renal hilum in the midsection of the left kidney. Subsequent pathological analysis classified the excised tumor as an eosinophilic vacuolar tumor of the kidney.</p><p><strong>Conclusion: </strong>This case illustrates that EVT represents a novel solid neoplasm of the kidney, with occurrences being exceedingly uncommon. It is imperative for clinicians and pathologists to enhance their comprehension of these tumors and distinguish them effectively, thereby facilitating more precise classification of renal tumors and informing clinical management and prognostic assessment.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"28"},"PeriodicalIF":1.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of methenamine hippurate in preventing urinary tract infections: an updated systematic review, meta-analysis and trial sequential analysis of randomized controlled trials.","authors":"Nathalie Cordeiro Hobaica, Giovanna Cardoso De Oliveira, Breno Cordeiro Porto, Carlo Camargo Passerotti, Rodrigo Afonso Da Silva Sardenberg, Jose Pinhata Otoch, Jose Arnaldo Shiomi Da Cruz","doi":"10.1186/s12894-025-01708-8","DOIUrl":"10.1186/s12894-025-01708-8","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary Tract Infections (UTIs) are a significant health problem worldwide, especially among women. methenamine hippurate has been proposed as a preventive measure against recurrent UTIs. This updated systematic review and meta-analysis aimed to evaluate the effectiveness of methenamine hippurate in preventing UTIs, incorporating the latest research findings and employing trial sequential analysis to assess the robustness of the evidence.</p><p><strong>Materials and methods: </strong>A systematic review was conducted across MEDLINE, Embase, Scopus, Cochrane, and Google Scholar up to March 2024 for randomized controlled trials comparing methenamine hippurate with placebo or antibiotic in adult women with a history of recurrent, confirmed UTIs. Key outcomes included symptomatic UTIs as primary outcome and positive urine culture, asymptomatic bacteriuria and adverse effects as secondary outcomes. It is important to state that asymptomatic UTIs with negative urine cultures were not adequately accounted for in the studies; therefore, this outcome was excluded from our meta-analysis. Additionally, adverse effects related to antibiotic resistance were not described in the studies, so only the adverse effects of the medications themselves were considered. The risk of bias was evaluated using the Cochrane Risk of Bias 2, and statistical analysis was conducted using RStudio software.</p><p><strong>Results: </strong>We retrieved 5 articles, encompassing 216 patients in the methenamine group and 205 patients in the control group (Antibiotic). Our analysis revealed non-inferiority in the rate of symptomatic UTI episodes between the two groups (RR 1.15; 95%CI 0.96,1.38; p = 0.41; I² = 0%). Similarly, there were no notable distinctions in the rate of positive urine cultures (RR 1.20; 95CI 0.91, 1.57; p = 0.25; I² = 28%), and the rate of adverse effects (RR 0.98; 95CI 0.86, 1.12; p = 0.35; I² = 9%). However, we observed a decreased frequency of asymptomatic bacteriuria in the control group (RR 1.91; 95CI 1.29, 2.81; p = 0.0001; I² = 0%). In trial sequential analysis, existing studies were not able to achieve the futility boundaries.</p><p><strong>Conclusions: </strong>Overall, our meta-analysis provides evidence supporting methenamine hippurate as an effective, non-inferior and safe prophylactic option for preventing recurrent UTIs in adult women, as demonstrated by the current evidence base. Nevertheless, more RCTs are necessary to achieve the futility boundaries in trial sequential analysis.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"30"},"PeriodicalIF":1.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible ureteroscopy combined with potassium sodium hydrogen citrate(PSHC) intervention improves the stone-free rate(SFR) for 20-30 mm uric acid renal stones.","authors":"Ru Huang, Min-Jun Jiang, Jian-Chun Chen, Zhi-Jun Cao, Zhen-Fan Wang, Zheng Ma, Guo-Bing Lin, Chen Xu","doi":"10.1186/s12894-025-01710-0","DOIUrl":"10.1186/s12894-025-01710-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of combining flexible ureteroscopy (FURS) with potassium sodium hydrogen citrate(PSHC) for the treatment of 20-30 mm uric acid renal stones.</p><p><strong>Methods: </strong>A retrospective analysis of outcomes of patients with 20-30 mm uric acid renal stones who were treated with FURS and holmium lithotripsy was conducted between July 2021 and May 2024. Of them, 60 patients accepted FURS combined potassium sodium hydrogen citrate(PSHC) therapy while 70 patients underwent the FURS procedure alone. The demographic data, stone characteristics, surgical details, and perioperative outcomes of the patients were assessed retrospectively. Stone-free status was defined as the complete absence of stones on computed tomography.</p><p><strong>Results: </strong>Totally 130 patients were enrolled and analyzed in this study. No significant differences were found between the two groups in terms of gender, age, body mass index, comorbidities, stone burden, stone density, number of stones, or laterality. The mean operation time, American Society of Anesthesiologists (ASA) score, postoperative stay, and complication rate were also similar between the groups. The combined group incurred higher costs (p < 0.01),but it achieved significantly higher stone-free rate and Wisconsin Stone Quality of Life Questionnaire score at 4 weeks post-operatively (96.7% vs. 85.7%,p = 0.029;124.63 vs. 114.44,p < 0.01). Additionally, the combined group had a significantly higher urine pH at 4 weeks postoperatively compared to the non-combined group (6.63 vs. 5.50, p < 0.01).</p><p><strong>Conclusion: </strong>Compared to a single procedure, FURS combined with PSHC therapy is an effective and safe treatment for 20-30 mm uric acid renal stones.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"29"},"PeriodicalIF":1.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of transurethral enucleation with bipolar energy for benign prostatic hyperplasia: single surgeon's initial experience.","authors":"Hwanik Kim, Jin Noh, Gyoohwan Jung, Seong Jin Jeong","doi":"10.1186/s12894-025-01706-w","DOIUrl":"10.1186/s12894-025-01706-w","url":null,"abstract":"<p><strong>Background: </strong>Transurethral enucleation with bipolar energy (TUEB) is one of endoscopic enucleation methods for the surgical treatment of benign prostatic hyperplasia (BPH). Authors investigated initial outcomes of TUEB performed by a single surgeon.</p><p><strong>Methods: </strong>From 04/2016 to 06/2021, prospectively collected clinical data of 387 patients who underwent TUEB were retrospectively analyzed. TUEB was performed by transurethral resection in a saline system with a spatula loop (one-lobe enucleation technique). Patients were stratified by surgery period (early vs. late) and evaluated perioperatively.</p><p><strong>Results: </strong>A total of 387 patients were included in the final analysis. Mean age was 72.4 years and total prostate volume was 73.1 cc as in the whole group. Total procedure time (116.0 vs. 116.8 min, p = 0.863), detailed procedure time (enucleation: 49.2 vs. 46.1 min, p = 0.099; morcellation: 26.5 vs. 23.6 min, p = 0.162) and enucleated tissue weight (26.1 g vs. 27.9 g, p = 0.350) did not differ significantly between groups. However, there were significant differences in enucleated tissue weight per unit time (g/min) (0.52 vs. 0.58, p = 0.037), reoperation rates due to bleeding (9.8% vs. 2.5%, p = 0.002), and conversion to transurethral prostatectomy (TURP) (19.2% vs. 1.5%, p < 0.001). At 6 months post-operatively, there were insignificant differences in the rates of de novo stress incontinence (p = 0.188), urethral stricture (p = 0.158), and bladder neck contracture (p = 0.477).</p><p><strong>Conclusion: </strong>TUEB is a safe and effective technique for the treatment of BPH, resulting in significant improvements in both subjective and objective symptoms. With increasing surgical experience, efficacy of the procedure has significantly improved in terms of both bleeding complication rates and TURP conversion rates.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"27"},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of curative radiotherapy for the treatment of elderly patients with muscle-invasive bladder cancer: a systematic review.","authors":"Masakuni Sakaguchi, Toshiya Maebayashi, Yuta Sekino, Hitoshi Ishikawa","doi":"10.1186/s12894-025-01707-9","DOIUrl":"10.1186/s12894-025-01707-9","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, a chemoradiotherapy has been developed as a radical treatment for stage II-III muscle-invasive bladder cancer (MIBC) that can preserve the bladder for patients who cannot tolerate radical cystectomy (RC) or who do not wish to undergo RC. However, most of the studies were conducted on younger patients with MIBC, and it is not clear if it is effective for elderly patients with MIBC. In this study, we reviewed the effects and adverse events after radical radiotherapy in elderly patients with MIBC to determine if radiotherapy has been/can be equally recommended for younger patients with MIBC.</p><p><strong>Methods: </strong>We extracted full research reports in English comparing treatment results between different age groups and reports targeting elderly patients with MIBC. A keyword search of the PubMed database was conducted in the decade ending on December 8, 2021. Studies reporting post-treatment overall survival (OS), relapse-free/progression-free/disease-free survival (RFS/PFS/DFS), disease-specific/cancer-specific survival (DSS/CSS), and complete response (CR) rate, adverse events (AEs), and quality of life (QOL) in elderly patients with MIBC were searched. Thirty-nine full articles, including those with comparisons by age group or treatments for elderly patients, were retrieved.</p><p><strong>Results: </strong>OS was significant or tended to be poor in elderly patients. There were no differences in PFS and CSS between younger and elderly patients. No differences in the rates of grade 3 morbidities between younger and elderly patients were also observed.</p><p><strong>Conclusion: </strong>The lack of a difference in PFS/CSS and toxicities between elderly and younger MIBC patients indicated that curative chemoradiotherapy is effective for not only younger but also elderly patients. With advances in treatment, further prospective studies are needed to optimize the management of MIBC in elderly patients.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"26"},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN): a prospective pilot study.","authors":"Xu Shi, Yang Yu, Tianrun Ye, Gan Yu, Bin Xu, Zheng Liu, Ke Chen, Wei Guan, Shaogang Wang, Heng Li","doi":"10.1186/s12894-025-01711-z","DOIUrl":"10.1186/s12894-025-01711-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate a novel intracorporeal minimally invasive procedure for robot assisted laparoendoscopic single-site partial nephrectomy.</p><p><strong>Methods: </strong>This study reported our technique and the outcomes of a minimally invasive approach for partial nephrectomy, specifically robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN). A Freeport for LESS was inserted through a 4.5-5.0 cm skin incision. Instead of the traditional renal artery clamping technique, a Fogarty balloon catheter was used to occlude the renal artery or its branch. Tumor resection and wound suturing was then performed as routine steps.</p><p><strong>Results: </strong>A total of 10 patients with T1 stage renal tumors underwent successful LESS-HPN from March to July 2023, with no conversions to renal artery clamping or additional ports. The mean operative time was 103.3 ± 11.1 min, including 21.0 ± 2.7 min of warm ischemia time. The mean estimated blood loss was 42.0 ± 22.5 ml. Tumors located posteriorly were associated with shorter operative time compared to those located anteriorly (p = 0.041). Occlusion of the main renal arteries, branch arteries, and accessory renal artery was achieved in 7, 2 and 1 cases, respectively. During a median follow-up of 10.5 months, no recurrence, metastasis, or death was observed. Limitations of this study include the small sample size, the absence of a control group, and the relatively short follow-up duration.</p><p><strong>Conclusions: </strong>LESS-HPN has proven to be a safe and feasible alternative for achieving intracorporeal minimal invasiveness in patients with renal tumors.</p><p><strong>Trial registration: </strong>Clinical trials were registered in September 4th, 2021, available at www.chictr.org.cn/ (ChiCTR2100050808). This article belongs to a selection of patients who were part of this clinical study.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"25"},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Knotted electrical wire with a glass tube at the top as a foreign body in a male urethra: a case report\".","authors":"Arian Karimi Rouzbahani, Bahar Amiri, Ahad Fazeli, Behzad Yousefi Yeganeh","doi":"10.1186/s12894-025-01703-z","DOIUrl":"10.1186/s12894-025-01703-z","url":null,"abstract":"<p><strong>Background: </strong>A large number of self-inflicted foreign bodies have been reported in the male urethra and urinary bladder. Polyembolokoilamania is a Greek derivative describing the behavioral phenomenon of inserting foreign objects into bodily orifices.</p><p><strong>Case presentation: </strong>We report a 27-year-old unmarried male who presented the emergency department after inserting a knotted electrical wire with a glass tube at the top of his bladder. The patient admitted he inserted soft objects into his penis for pleasure, curiosity, feelings of emptiness, and the need for sexual excitement. A pelvic x-ray confirmed the presence of a knotted wire stump within the urinary bladder. Faced with these challenges, we tried utilizing a 7.5 F, 26-cm pediatric flexible cystoscope. Despite our best efforts, the tightness of the knot proved insurmountable. Under spinal anesthesia, a suprapubic cystotomy was performed, and the wire was untied and retrieved from the urinary bladder via the urethra.</p><p><strong>Conclusion: </strong>When the urethra is too narrow for an adult cystoscope, a pediatric cystoscope can be a considerable intervention option.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"24"},"PeriodicalIF":1.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty.","authors":"Mazen O Kurdi","doi":"10.1186/s12894-025-01699-6","DOIUrl":"10.1186/s12894-025-01699-6","url":null,"abstract":"<p><strong>Background: </strong>Deficient ventral prepuce is a rare anomaly of prepuce with normally situated meatus. It is usually associated with this or hypoplastic urethra.</p><p><strong>Methods: </strong>A retrospective study included all infants diagnosed with a ventrally hooded prepuce. A penile degloving was the first step. Then reinforcement of the hypoplastic urethra by spongioplasty was performed. Sleeve resection of the hooded prepuce and reconstruction of sulcus corona was the last step.</p><p><strong>Results: </strong>The mean operative time was 44 ± 9.5 min. A hypoplastic urethra was reported in 35 cases (30.4%). A urethral stent was inserted at the beginning of the procedure and removed at the end. Twelve patients (10.4%) developed urethral cutaneous fistulas by the end of the first postoperative month.</p><p><strong>Conclusion: </strong>A hooded ventral prepuce with ventral chordee and normally situated meatus presents a challenge for paediatric surgeons. It is usually associated with a hypoplastic urethra. Attempts should be made to correct the chordee and preserve the urethra. The preserved urethra can be reinforced with spongioplasty. Unintended urethral injuries are common during dissection. Therefore, repairing the injury, reinforcing the dartos pedicle flap, and spongioplasty are suitable options. It is possible to preserve the urethra in patients having chordee without hypospadias. Utmost care should be taken to avoid urethral injuries which are common because shaft skin is stuck to the urethral skin. Urethral injuries can be repaired primarily; however, there is a high incidence of fistula.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"23"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring of prostate-specific antigen in men with benign prostate enlargement receiving 5-alpha reductase inhibitors: a non-interventional, cross-sectional study of real-world practice of urologists in Spain and Brazil.","authors":"Juan Manuel Palacios, Pratiksha Kapse, Vanessa Cortes, Marcio Augusto Averbeck, Alberto Budia Alba, Suryakant Somvanshi, Danilo Souza Lima da Costa Cruz, Fiona Pereira","doi":"10.1186/s12894-025-01701-1","DOIUrl":"10.1186/s12894-025-01701-1","url":null,"abstract":"<p><strong>Background: </strong>Inconsistent monitoring of prostate-specific antigen in patients receiving 5-alpha reductase inhibitors for lower urinary tract symptoms/benign prostate enlargement may affect prostate cancer outcomes. This study evaluated real-world practice among urologists treating patients receiving 5-alpha reductase inhibitors.</p><p><strong>Methods: </strong>This non-interventional, cross-sectional study collected data from urologists in Spain (N = 100) and Brazil (N = 100) via a self-reporting questionnaire and patient record forms. Endpoints included: frequency/methodology of prostate-specific antigen monitoring, concerns about the effect of 5-alpha reductase inhibitors on prostate-specific antigen monitoring, triggers of prostate biopsy, and concerns when switching 5-alpha reductase inhibitor formulation.</p><p><strong>Results: </strong>Over half of urologists monitored prostate-specific antigen every 6 months (Spain 59%, Brazil 58%). Preferred methods were the \"doubling rule\" (Spain 66%, Brazil 41%) and \"increase from nadir\" (Spain 28%, Brazil 43%). A minority of urologists monitored unadjusted values (Spain 3%, Brazil 11%) or did not monitor prostate-specific antigen (Spain 1%, Brazil 3%). Most urologists ranked the potential for 5-alpha reductase inhibitors to mask prostate cancer as their top concern (Spain 65%, Brazil 56%). The most selected trigger for prostate biopsy was \"if doubled (adjusted) prostate-specific antigen level after 6 months of treatment is > 4 ng/mL\" (Spain 39%, Brazil 37%). Many urologists were moderately/very concerned about the effect on prostate-specific antigen when switching 5-alpha reductase inhibitor formulation.</p><p><strong>Conclusions: </strong>An unmet need exists for standard guidance and continuous education to support optimal monitoring and interpretation of prostate-specific antigen in patients with lower urinary tract symptoms/benign prostate enlargement treated with 5-alpha reductase inhibitors.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"22"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}