Pub Date : 2026-02-01Epub Date: 2025-11-21DOI: 10.1111/iju.70290
Retraction: A Y. Mahmoud, S. Gouda, I. Gamaan and M. A. Baky Fahmy, "Autologous Platelet-Rich Plasma Covering Urethroplasty Versus Dartos Flap in Distal Hypospadias Repair: A Prospective Randomized Study," International Journal of Urology 26, no. 4 (2019): 475-480, https://doi.org/10.1111/iju.13912. The above article, published online on 04 February 2019, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Naoya Masumori; the Japanese Urological Association; and John Wiley & Sons Australia, Ltd. The retraction has been agreed upon following concerns raised by a third-party regarding duplication of images previously published in another article by a different group of authors. An investigation confirmed the images were duplicated and used to represent a different scientific context. The authors acknowledged that the images were inappropriately used and apologized for this misuse. The editors consider the results and conclusions invalid. The authors disagree with the retraction.
引用本文：A. Y. Mahmoud， S. Gouda， I. Gamaan， M. A. Baky Fahmy，“自体富血小板血浆覆盖尿道成形术与Dartos皮瓣修复尿道下裂远端：一项前瞻性随机研究”，国际泌尿外科杂志，26,no. 1。4 (2019): 475-480, https://doi.org/10.1111/iju.13912。上述文章于2019年2月4日在线发表在Wiley在线图书馆（wileyonlinelibrary.com）上，经该杂志总编辑Naoya Masumori；日本泌尿学会；及John Wiley & Sons Australia有限公司由于第三方对另一组作者先前在另一篇文章中发表的重复图像提出了担忧，因此同意撤回。一项调查证实，这些图像是重复的，并被用来代表不同的科学背景。作者承认这些图片被不恰当地使用，并为这种滥用道歉。编辑认为结果和结论无效。作者不同意撤稿。
{"title":"RETRACTION: Autologous Platelet-Rich Plasma Covering Urethroplasty Versus Dartos Flap in Distal Hypospadias Repair: A Prospective Randomized Study.","authors":"","doi":"10.1111/iju.70290","DOIUrl":"10.1111/iju.70290","url":null,"abstract":"<p><strong>Retraction: </strong>A Y. Mahmoud, S. Gouda, I. Gamaan and M. A. Baky Fahmy, \"Autologous Platelet-Rich Plasma Covering Urethroplasty Versus Dartos Flap in Distal Hypospadias Repair: A Prospective Randomized Study,\" International Journal of Urology 26, no. 4 (2019): 475-480, https://doi.org/10.1111/iju.13912. The above article, published online on 04 February 2019, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Naoya Masumori; the Japanese Urological Association; and John Wiley & Sons Australia, Ltd. The retraction has been agreed upon following concerns raised by a third-party regarding duplication of images previously published in another article by a different group of authors. An investigation confirmed the images were duplicated and used to represent a different scientific context. The authors acknowledged that the images were inappropriately used and apologized for this misuse. The editors consider the results and conclusions invalid. The authors disagree with the retraction.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":"e70290"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and objective: Treatment selection for metastatic castration-sensitive prostate cancer (mCSPC) remains challenging, as reliable and practical biomarkers predicting response to androgen receptor pathway inhibitor (ARPI)-based therapy are limited. We evaluated whether prostate-specific antigen (PSA) and Ki-67 expression in diagnostic biopsy specimens can predict oncologic outcomes in patients with mCSPC treated with ARPI-androgen deprivation therapy (ADT) doublet therapy, and whether these biomarkers can guide optimal treatment selection.
Methods: This retrospective multicenter study included 58 patients with mCSPC who received ARPI-ADT doublet therapy between 2018 and 2024. Immunohistochemical staining for PSA and Ki-67 was performed on diagnostic biopsy specimens. Receiver operating characteristic curve analyses were used to determine optimal cutoff values for predicting progression to castration-resistant prostate cancer (CRPC). Survival outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards models. Exploratory analyses included patients treated with triplet therapy (ADT + docetaxel + darolutamide) or upfront docetaxel.
Results: Low PSA expression, high Ki-67 expression, and a bone metastasis extent of disease (EOD) score ≥ 3 were independently associated with shorter CRPC-free survival (CRPC-FS). Stratification by risk factors (0, 1, or 2) showed a stepwise decline in CRPC-FS. In exploratory analyses, triplet therapy achieved the longest CRPC-FS and progression-free survival 2 among high-risk patients, whereas no significant differences among treatment modalities were observed in the low-risk group.
Conclusion: Immunohistochemical PSA and Ki-67 expression provide practical prognostic information for patients with metastatic castration-sensitive prostate cancer. Combined assessment with EOD ≥ 3 identifies a high-risk subgroup with unfavorable clinical outcomes.
{"title":"Impact of Immunohistochemical PSA and Ki-67 Expression on Prognosis in Metastatic Castration-Sensitive Prostate Cancer.","authors":"Miyaka Umemori, Fumihiko Urabe, Yuya Iwamoto, Yu Imai, Kojiro Tashiro, Shun Sato, Hiroyuki Takahashi, Takahiro Kimura","doi":"10.1111/iju.70368","DOIUrl":"https://doi.org/10.1111/iju.70368","url":null,"abstract":"<p><strong>Background and objective: </strong>Treatment selection for metastatic castration-sensitive prostate cancer (mCSPC) remains challenging, as reliable and practical biomarkers predicting response to androgen receptor pathway inhibitor (ARPI)-based therapy are limited. We evaluated whether prostate-specific antigen (PSA) and Ki-67 expression in diagnostic biopsy specimens can predict oncologic outcomes in patients with mCSPC treated with ARPI-androgen deprivation therapy (ADT) doublet therapy, and whether these biomarkers can guide optimal treatment selection.</p><p><strong>Methods: </strong>This retrospective multicenter study included 58 patients with mCSPC who received ARPI-ADT doublet therapy between 2018 and 2024. Immunohistochemical staining for PSA and Ki-67 was performed on diagnostic biopsy specimens. Receiver operating characteristic curve analyses were used to determine optimal cutoff values for predicting progression to castration-resistant prostate cancer (CRPC). Survival outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards models. Exploratory analyses included patients treated with triplet therapy (ADT + docetaxel + darolutamide) or upfront docetaxel.</p><p><strong>Results: </strong>Low PSA expression, high Ki-67 expression, and a bone metastasis extent of disease (EOD) score ≥ 3 were independently associated with shorter CRPC-free survival (CRPC-FS). Stratification by risk factors (0, 1, or 2) showed a stepwise decline in CRPC-FS. In exploratory analyses, triplet therapy achieved the longest CRPC-FS and progression-free survival 2 among high-risk patients, whereas no significant differences among treatment modalities were observed in the low-risk group.</p><p><strong>Conclusion: </strong>Immunohistochemical PSA and Ki-67 expression provide practical prognostic information for patients with metastatic castration-sensitive prostate cancer. Combined assessment with EOD ≥ 3 identifies a high-risk subgroup with unfavorable clinical outcomes.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":"e70368"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To investigate the safety and efficacy of mini-endoscopic combined intrarenal surgery (ECIRS) in older patients with renal and ureteral stones.
Methods: Consecutive patients with renal or ureteral stones who underwent mini-ECIRS were retrospectively analyzed at three Japanese tertiary care institutions between 2015 and 2021. Data on patient backgrounds, stone characteristics, and postoperative indications were collected and evaluated. After matching preoperative and intraoperative factors in older patients and other groups, postoperative factors were assessed using univariate analysis.
Results: The final analysis included data from 1303 single-session mini-ECIRS of 1432 cases collected. The patients were divided into two groups: those aged > 75 and those aged < 75 years, with 121 and 1182 patients. From each group, 112 cases matched for eight factors, performance status, body mass index, sex, hydronephrosis, percutaneous nephrostomy, pyuria, preoperative urinary tract infection, and preoperative ureteral stenting, were selected. The univariate analysis was performed on postoperative factors between the groups of matched older and matched non-older patients, and there was no significant difference in any factor, including postoperative hospitalization duration, complications, and stone-free rate (SFR).
Conclusions: To the best of our knowledge, this multicenter cohort study is the first to compare the efficacy and safety of the mini-ECIRS between older patients and other groups. It was discovered that surgery could be performed with a similar quality even in patients aged 75 and older compared to that in other groups.
{"title":"Outcomes of Mini-Endoscopic Combined Intrarenal Surgery in the Geriatric Population: A Matched-Pair Analysis.","authors":"Takahiko Watanabe, Hiroki Ito, Tetsuo Fukuda, Fukashi Yamamichi, Yosuke Shibata, Tadashi Tabei, Kazuhide Makiyama, Takaaki Inoue, Junichi Matsuzaki, Kazuki Kobayashi","doi":"10.1111/iju.70372","DOIUrl":"https://doi.org/10.1111/iju.70372","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the safety and efficacy of mini-endoscopic combined intrarenal surgery (ECIRS) in older patients with renal and ureteral stones.</p><p><strong>Methods: </strong>Consecutive patients with renal or ureteral stones who underwent mini-ECIRS were retrospectively analyzed at three Japanese tertiary care institutions between 2015 and 2021. Data on patient backgrounds, stone characteristics, and postoperative indications were collected and evaluated. After matching preoperative and intraoperative factors in older patients and other groups, postoperative factors were assessed using univariate analysis.</p><p><strong>Results: </strong>The final analysis included data from 1303 single-session mini-ECIRS of 1432 cases collected. The patients were divided into two groups: those aged > 75 and those aged < 75 years, with 121 and 1182 patients. From each group, 112 cases matched for eight factors, performance status, body mass index, sex, hydronephrosis, percutaneous nephrostomy, pyuria, preoperative urinary tract infection, and preoperative ureteral stenting, were selected. The univariate analysis was performed on postoperative factors between the groups of matched older and matched non-older patients, and there was no significant difference in any factor, including postoperative hospitalization duration, complications, and stone-free rate (SFR).</p><p><strong>Conclusions: </strong>To the best of our knowledge, this multicenter cohort study is the first to compare the efficacy and safety of the mini-ECIRS between older patients and other groups. It was discovered that surgery could be performed with a similar quality even in patients aged 75 and older compared to that in other groups.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":"e70372"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and objective: The PEACE-3 trial demonstrated overall survival benefit for enzalutamide plus radium-223 versus enzalutamide alone in metastatic castration-resistant prostate cancer (mCRPC), but survival curves showed initial crossing followed by progressive separation, indicating non-proportional hazards. We aimed to characterize the time-dependent treatment effects through comprehensive analysis.
Methods: Individual patient datas (IPD) were reconstructed from published Kaplan-Meier curves of the PEACE-3 trial. Time-dependent treatment effects were evaluated by restricted mean survival time (RMST) analysis at predefined time points (18-72 months), time-dependent Cox regression with treatment-by-time interaction, piecewise Cox regression across 6 time intervals, landmark analyses, and Fleming-Harrington weighted log-rank tests.
Results: A total of 446 IPDs were reconstructed. Validation confirmed consistency with the original trial. During the initial 18 months, combination therapy showed no survival advantage (RMST difference: -0.36 months, 95% CI, -0.90 to 0.18, p = 0.20) and was associated with increased hazard (HR = 2.14, 95% CI, 1.48-3.10, p < 0.001). Significant survival benefits were observed after 60 months, with RMST differences of 4.34 months (95% CI, 0.49-8.19, p = 0.03) at 60 months and 6.25 months (95% CI, 1.56-10.95, p = 0.01) at 72 months. Time-dependent Cox regression confirmed a significant treatment-by-time interaction (p < 0.01). Piecewise analysis revealed the most substantial benefit for 60-72 months (HR = 0.20, 95% CI, 0.05-0.77, p = 0.02). Landmark analyses consistently demonstrated increasing treatment benefit with longer follow-up.
Conclusions: Enzalutamide plus radium-223 demonstrates delayed but substantial survival benefit in mCRPC, becoming statistically significant after 60 months with over 6 months survival advantage at 72 months. REGISTRY AND THE REGISTRATION NO.
{"title":"Delayed Survival Benefit of Enzalutamide Plus Radium-223 in Metastatic Castration-Resistant Prostate Cancer: A Time-Dependent Analysis of Reconstructed Individual Patient Data From the PEACE-3 Trial.","authors":"Wei Chen, Soichiro Yoshida, Shugo Yajima, Kenji Tanabe, Motohiro Fujiwara, Hiroshi Fukushima, Hajime Tanaka, Akihiro Hirakawa, Hitoshi Masuda, Yasuhisa Fujii","doi":"10.1111/iju.70376","DOIUrl":"https://doi.org/10.1111/iju.70376","url":null,"abstract":"<p><strong>Background and objective: </strong>The PEACE-3 trial demonstrated overall survival benefit for enzalutamide plus radium-223 versus enzalutamide alone in metastatic castration-resistant prostate cancer (mCRPC), but survival curves showed initial crossing followed by progressive separation, indicating non-proportional hazards. We aimed to characterize the time-dependent treatment effects through comprehensive analysis.</p><p><strong>Methods: </strong>Individual patient datas (IPD) were reconstructed from published Kaplan-Meier curves of the PEACE-3 trial. Time-dependent treatment effects were evaluated by restricted mean survival time (RMST) analysis at predefined time points (18-72 months), time-dependent Cox regression with treatment-by-time interaction, piecewise Cox regression across 6 time intervals, landmark analyses, and Fleming-Harrington weighted log-rank tests.</p><p><strong>Results: </strong>A total of 446 IPDs were reconstructed. Validation confirmed consistency with the original trial. During the initial 18 months, combination therapy showed no survival advantage (RMST difference: -0.36 months, 95% CI, -0.90 to 0.18, p = 0.20) and was associated with increased hazard (HR = 2.14, 95% CI, 1.48-3.10, p < 0.001). Significant survival benefits were observed after 60 months, with RMST differences of 4.34 months (95% CI, 0.49-8.19, p = 0.03) at 60 months and 6.25 months (95% CI, 1.56-10.95, p = 0.01) at 72 months. Time-dependent Cox regression confirmed a significant treatment-by-time interaction (p < 0.01). Piecewise analysis revealed the most substantial benefit for 60-72 months (HR = 0.20, 95% CI, 0.05-0.77, p = 0.02). Landmark analyses consistently demonstrated increasing treatment benefit with longer follow-up.</p><p><strong>Conclusions: </strong>Enzalutamide plus radium-223 demonstrates delayed but substantial survival benefit in mCRPC, becoming statistically significant after 60 months with over 6 months survival advantage at 72 months. REGISTRY AND THE REGISTRATION NO.</p><p><strong>Of the study/trial: </strong>Not applicable.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":"e70376"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease. In this study, we aimed to evaluate the efficacy of photodynamic diagnosis (PDD)-assisted transurethral resection of the bladder (TURBT) using the recently validated International Bladder Cancer Group (IBCG) risk stratification model for IR-NMIBC.
Methods
We conducted a single-center retrospective analysis of 193 patients with IR-NMIBC who underwent either PDD-assisted with oral 5-aminolevulinic acid (n = 69) or white-light (WL) TURBT (n = 126) between 2009 and 2023. We performed 1:1 propensity score matching (PSM) to balance baseline characteristics. Recurrence-free survival (RFS) was compared between the groups using the Kaplan–Meier method with subgroup analyses based on IBCG risk strata (IR-low, IR-intermediate/high).
Results
After PSM, 69 patients with well-balanced characteristics remained in each group. PDD was associated with a significantly improved RFS compared with WL-TURBT in the overall cohort (p = 0.016). Using subgroup analysis, this benefit was most pronounced in the IR-low risk group (p = 0.025), whereas no significant difference was found in the IR-intermediate/high-risk group (p = 0.14). Regarding multivariate analysis, PDD was an independent predictor of improved RFS in both the entire IR cohort (hazard ratio [HR]: 0.421, p = 0.009) and IR-low subgroup (HR: 0.361, p = 0.047).
Conclusions
PDD-assisted TURBT significantly improved the recurrence outcomes in patients with IR-NMIBC, with the greatest benefit observed in the IR-low risk subgroup. These findings support a stratified approach in which PDD is a cornerstone of management of IR-low patients, while highlighting the need for further research to optimize treatment strategies for IR-intermediate/high patients.
{"title":"Efficacy of Photodynamic Diagnosis Is Confined to the Low-Risk Subgroup of Intermediate-Risk Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched Analysis","authors":"Yohei Abe, Rikiya Taoka, Asuka Kaji, Satoshi Harada, Kengo Fujiwara, Kana Kohashiguchi, Hirohito Naito, Yoichiro Tohi, Takuma Kato, Homare Okazoe, Nobufumi Ueda, Mikio Sugimoto","doi":"10.1111/iju.70365","DOIUrl":"10.1111/iju.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease. In this study, we aimed to evaluate the efficacy of photodynamic diagnosis (PDD)-assisted transurethral resection of the bladder (TURBT) using the recently validated International Bladder Cancer Group (IBCG) risk stratification model for IR-NMIBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center retrospective analysis of 193 patients with IR-NMIBC who underwent either PDD-assisted with oral 5-aminolevulinic acid (<i>n</i> = 69) or white-light (WL) TURBT (<i>n</i> = 126) between 2009 and 2023. We performed 1:1 propensity score matching (PSM) to balance baseline characteristics. Recurrence-free survival (RFS) was compared between the groups using the Kaplan–Meier method with subgroup analyses based on IBCG risk strata (IR-low, IR-intermediate/high).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, 69 patients with well-balanced characteristics remained in each group. PDD was associated with a significantly improved RFS compared with WL-TURBT in the overall cohort (<i>p</i> = 0.016). Using subgroup analysis, this benefit was most pronounced in the IR-low risk group (<i>p</i> = 0.025), whereas no significant difference was found in the IR-intermediate/high-risk group (<i>p</i> = 0.14). Regarding multivariate analysis, PDD was an independent predictor of improved RFS in both the entire IR cohort (hazard ratio [HR]: 0.421, <i>p</i> = 0.009) and IR-low subgroup (HR: 0.361, <i>p</i> = 0.047).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PDD-assisted TURBT significantly improved the recurrence outcomes in patients with IR-NMIBC, with the greatest benefit observed in the IR-low risk subgroup. These findings support a stratified approach in which PDD is a cornerstone of management of IR-low patients, while highlighting the need for further research to optimize treatment strategies for IR-intermediate/high patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To validate, for the first time in patients with bladder cancer who underwent radical cystectomy, the recently developed 7-item Quality of Life Disease-specific Impact Scale (QDIS-7), a brief, unidimensional instrument designed for cross-condition comparisons.
Methods
In this cross-sectional study conducted at 24 facilities, patients aged ≥ 20 years who were 3 months post-radical cystectomy for bladder cancer completed self-reported questionnaires. The enrollment period was from January 2020 to October 2022. Quality of life measures included the QDIS-7, the Bladder Cancer Index (BCI), and the Body Image Scale (BIS). Confirmatory factor analysis was performed to test the hypothesized one-factor structure of the QDIS-7. Internal consistency reliability was assessed using Cronbach's alpha coefficient. Criterion-based validity was evaluated using Spearman's correlation coefficients (ρ) between the QDIS-7 scores and the BCI bother subdomains and BIS scores.
Results
In total, 205 patients (median age, 71 years; 78.5% male) were included. The QDIS-7 score showed no floor or ceiling effects. Confirmatory factor analysis supported the one-factor model (factor loadings, 0.71–0.94). Internal consistency reliability was high (Cronbach's alpha, 0.94). The QDIS-7 score showed moderate correlations with the BIS and the BCI urinary and bowel bother subdomain scores (ρ = 0.654, −0.560, and −0.475, respectively).
Conclusions
The QDIS-7 effectively captured urinary and bowel symptom burden and body image impairment in patients undergoing radical cystectomy for bladder cancer. Its brevity, strong psychometric properties, and capacity for comparisons across conditions support its use in patient-centered research.
{"title":"Validation of the 7-Item Quality of Life Disease-Specific Impact Scale in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Cross-Sectional Study","authors":"Sayaka Shimizu, Takahiro Osawa, Miho Sato, Shuhei Yamada, Toru Harabayashi, Jun Miki, Takashi Kobayashi, Katsuyoshi Hashine, Atsunari Kawashima, Takashi Matsumoto, Takanori Mochizuki, Rikiya Taoka, Fumihiko Urabe, Shuichi Tatarano, Atsuro Sawada, Takahiro Kojima, Atsushi Takahashi, Akira Yokomizo, Shigetaka Suekane, Kohei Hashimoto, Yasuhiro Hashimoto, Junji Yatsuda, Ken Morita, Keita Kobayashi, Yohei Satake, Ataru Sazawa, Yoshiyuki Matsui, Yoichi M. Ito, Hiroyuki Nishiyama, Hiroshi Kitamura, Nobuo Shinohara, Shunichi Fukuhara, the Japanese Urological Oncology Group","doi":"10.1111/iju.70364","DOIUrl":"10.1111/iju.70364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To validate, for the first time in patients with bladder cancer who underwent radical cystectomy, the recently developed 7-item Quality of Life Disease-specific Impact Scale (QDIS-7), a brief, unidimensional instrument designed for cross-condition comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study conducted at 24 facilities, patients aged ≥ 20 years who were 3 months post-radical cystectomy for bladder cancer completed self-reported questionnaires. The enrollment period was from January 2020 to October 2022. Quality of life measures included the QDIS-7, the Bladder Cancer Index (BCI), and the Body Image Scale (BIS). Confirmatory factor analysis was performed to test the hypothesized one-factor structure of the QDIS-7. Internal consistency reliability was assessed using Cronbach's alpha coefficient. Criterion-based validity was evaluated using Spearman's correlation coefficients (ρ) between the QDIS-7 scores and the BCI bother subdomains and BIS scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 205 patients (median age, 71 years; 78.5% male) were included. The QDIS-7 score showed no floor or ceiling effects. Confirmatory factor analysis supported the one-factor model (factor loadings, 0.71–0.94). Internal consistency reliability was high (Cronbach's alpha, 0.94). The QDIS-7 score showed moderate correlations with the BIS and the BCI urinary and bowel bother subdomain scores (<i>ρ</i> = 0.654, −0.560, and −0.475, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The QDIS-7 effectively captured urinary and bowel symptom burden and body image impairment in patients undergoing radical cystectomy for bladder cancer. Its brevity, strong psychometric properties, and capacity for comparisons across conditions support its use in patient-centered research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trail Registration</h3>\u0000 \u0000 <p>UMIN-CTR (UMIN000039538)</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tshering D. Bhutia, Prashanth K. Marla, Pritham Sharma, Roshan V. Shetty, Sunil P. Shenoy
{"title":"“CRADLE TECHNIQUE”: A “no Touch” Method of kidney handling during transplantation","authors":"Tshering D. Bhutia, Prashanth K. Marla, Pritham Sharma, Roshan V. Shetty, Sunil P. Shenoy","doi":"10.1111/iju.70301","DOIUrl":"10.1111/iju.70301","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Despite the male dominance in Japanese urology, female representation has been rapidly increasing in recent years. However, female role models are scarce. Understanding the extent of leadership motivation among female urologists by career stage and its relationship to role-model exposure can inform targeted interventions to strengthen the leadership pipeline.</p><p>Over Forty Female Urologists Consortium_UROlogy (OFFUCURO), established in 2024, supports long-term career development for female urologists through peer networking and mentorship. As of August 2025, it includes 114 members (women and men), representing approximately 10% of the Japanese Urological Association (JUA)-registered female urologists. We conducted a cross-sectional, web-based survey of OFFUCURO members (<i>n</i> = 114) from August 29 to September 11, 2025. Participation was voluntary and anonymous, and informed consent was obtained electronically. The questionnaire used the validated Japanese wording of the original 27-item Motivation to Lead (MTL) scale [<span>1, 2</span>]. Items were rated on a 5-point scale, and reverse-worded items were standard reverse-coded. The scale comprises three subscales—affective-identity (AI-MTL), non-calculative (NC-MTL), and social-normative (SN-MTL). We compared women aged < 40 years, women aged ≥ 40 years, and men using Kruskal–Wallis tests with Steel–Dwass post hoc tests, performed using EZR software. We also assessed role models and work–family balance concerns.</p><p>Of the 62 respondents (response rate, 54.4%), 61 were analyzed after excluding one respondent because of missing information on sex (women, 50; men, 11). All male respondents were aged ≥ 40 years. Among women, 18 (36.0%) were < 40 years old and 32 (64.0%) were ≥ 40 years old. Role-model exposure differed by age group; younger women cited male/mixed role models more often, whereas women aged ≥ 40 years cited female/mixed role models. Work–family balance concerns were reported by 14/18 (77.8%) women aged < 40 years, 16/32 (50.0%) women aged ≥ 40 years, and 5/11 (45.5%) men aged ≥ 40 years.</p><p>Figure 1 shows MTL comparisons. Kruskal–Wallis tests indicated overall differences for AI-MTL (<i>p</i> = 0.039) and NC-MTL (<i>p</i> = 0.0037), but not for SN-MTL (<i>p</i> = 0.159). In the Steel–Dwass tests, NC-MTL was lower in women aged < 40 years than in those aged ≥ 40 years (adjusted <i>p</i> = 0.0043) and men (adjusted <i>p</i> = 0.039). AI-MTL showed a trend toward higher scores in women ≥ 40 years than in those aged < 40 years (<i>p</i> = 0.062).</p><p>These patterns are consistent with the practice-relevant interpretation. Early career clinicians face tighter schedules, fewer support resources, and multiple transitions; leadership costs feel larger and benefits are less certain, especially when work–family balance is salient [<span>3, 4</span>]. By mid-career, work routines often stabilize, family responsibilities shift, and greater autonomy reduces perceive
{"title":"Leadership Motivation and Role Model Influence Among Japanese Female Urologists: A Cross-Sectional Pilot Study From Over Forty Female Urologists Consortium_UROlogy","authors":"Sachiyo Nishida, Chie Matsushita, Yasuyo Yamamoto, Tomoko Kobayashi, Maki Kawasaki, Hitomi Sasaki","doi":"10.1111/iju.70362","DOIUrl":"10.1111/iju.70362","url":null,"abstract":"<p>Despite the male dominance in Japanese urology, female representation has been rapidly increasing in recent years. However, female role models are scarce. Understanding the extent of leadership motivation among female urologists by career stage and its relationship to role-model exposure can inform targeted interventions to strengthen the leadership pipeline.</p><p>Over Forty Female Urologists Consortium_UROlogy (OFFUCURO), established in 2024, supports long-term career development for female urologists through peer networking and mentorship. As of August 2025, it includes 114 members (women and men), representing approximately 10% of the Japanese Urological Association (JUA)-registered female urologists. We conducted a cross-sectional, web-based survey of OFFUCURO members (<i>n</i> = 114) from August 29 to September 11, 2025. Participation was voluntary and anonymous, and informed consent was obtained electronically. The questionnaire used the validated Japanese wording of the original 27-item Motivation to Lead (MTL) scale [<span>1, 2</span>]. Items were rated on a 5-point scale, and reverse-worded items were standard reverse-coded. The scale comprises three subscales—affective-identity (AI-MTL), non-calculative (NC-MTL), and social-normative (SN-MTL). We compared women aged < 40 years, women aged ≥ 40 years, and men using Kruskal–Wallis tests with Steel–Dwass post hoc tests, performed using EZR software. We also assessed role models and work–family balance concerns.</p><p>Of the 62 respondents (response rate, 54.4%), 61 were analyzed after excluding one respondent because of missing information on sex (women, 50; men, 11). All male respondents were aged ≥ 40 years. Among women, 18 (36.0%) were < 40 years old and 32 (64.0%) were ≥ 40 years old. Role-model exposure differed by age group; younger women cited male/mixed role models more often, whereas women aged ≥ 40 years cited female/mixed role models. Work–family balance concerns were reported by 14/18 (77.8%) women aged < 40 years, 16/32 (50.0%) women aged ≥ 40 years, and 5/11 (45.5%) men aged ≥ 40 years.</p><p>Figure 1 shows MTL comparisons. Kruskal–Wallis tests indicated overall differences for AI-MTL (<i>p</i> = 0.039) and NC-MTL (<i>p</i> = 0.0037), but not for SN-MTL (<i>p</i> = 0.159). In the Steel–Dwass tests, NC-MTL was lower in women aged < 40 years than in those aged ≥ 40 years (adjusted <i>p</i> = 0.0043) and men (adjusted <i>p</i> = 0.039). AI-MTL showed a trend toward higher scores in women ≥ 40 years than in those aged < 40 years (<i>p</i> = 0.062).</p><p>These patterns are consistent with the practice-relevant interpretation. Early career clinicians face tighter schedules, fewer support resources, and multiple transitions; leadership costs feel larger and benefits are less certain, especially when work–family balance is salient [<span>3, 4</span>]. By mid-career, work routines often stabilize, family responsibilities shift, and greater autonomy reduces perceive","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052058","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}
The aim of this randomized control trial is to evaluate the effect of patient-controlled irrigation on pain and anxiety during outpatient flexible cystoscopy in male patients.
Materials and Methods
From April to June 2025, a prospective, double-blind randomized controlled trial was conducted. Male outpatients undergoing diagnostic flexible cystoscopy were randomly allocated to either squeeze a functioning water bag connected to the irrigation system (patient-controlled bag squeeze group) or a disconnected sham bag (standard irrigation group). The primary outcome was Visual Analogue Scale for pain. Secondary outcomes included changes in the State–Trait Anxiety Inventory, Visual Analogue Scale for satisfaction, physiological metrics, and patient preference regarding self-involvement in bag squeezing.
Results
A total of 50 patients were randomized to the patient-controlled bag squeeze (n = 24) or standard irrigation (n = 26) group. Baseline characteristics were similar between groups. The patient-controlled bag squeeze group demonstrated significantly higher irrigation volume and flow rate, with no difference in procedure duration. Pain scores were significantly lower (p = 0.0001) and satisfaction scores higher (p = 0.006) in the patient-controlled bag squeeze group. A significantly greater proportion of patients in the patient-controlled bag squeeze group reported a favorable preference for the intervention (p = 0.002). No differences were seen in physiological measures or anxiety reduction, and no infections occurred.
Conclusions
Patient-controlled bag squeeze appears to be a safe and effective analgesia method comparable to caregiver-assisted methods, and demonstrates favorable patient preference.
Trial Registration
University Hospital Medical Information Network clinical trials registry, Japan: UMIN000057485
{"title":"Impact of Patient-Controlled Bag Squeeze on Pain and Anxiety in Male Patients Undergoing Flexible Cystoscopy: A Double-Blind Randomized Control Study","authors":"Atsushi Wanifuchi, Toshiaki Tanaka, Ippei Muranaka, Tetsuya Shindo, Yuki Kyoda, Kohei Hashimoto, Naoya Masumori","doi":"10.1111/iju.70361","DOIUrl":"10.1111/iju.70361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The aim of this randomized control trial is to evaluate the effect of patient-controlled irrigation on pain and anxiety during outpatient flexible cystoscopy in male patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>From April to June 2025, a prospective, double-blind randomized controlled trial was conducted. Male outpatients undergoing diagnostic flexible cystoscopy were randomly allocated to either squeeze a functioning water bag connected to the irrigation system (patient-controlled bag squeeze group) or a disconnected sham bag (standard irrigation group). The primary outcome was Visual Analogue Scale for pain. Secondary outcomes included changes in the State–Trait Anxiety Inventory, Visual Analogue Scale for satisfaction, physiological metrics, and patient preference regarding self-involvement in bag squeezing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 50 patients were randomized to the patient-controlled bag squeeze (<i>n</i> = 24) or standard irrigation (<i>n</i> = 26) group. Baseline characteristics were similar between groups. The patient-controlled bag squeeze group demonstrated significantly higher irrigation volume and flow rate, with no difference in procedure duration. Pain scores were significantly lower (<i>p</i> = 0.0001) and satisfaction scores higher (<i>p</i> = 0.006) in the patient-controlled bag squeeze group. A significantly greater proportion of patients in the patient-controlled bag squeeze group reported a favorable preference for the intervention (<i>p</i> = 0.002). No differences were seen in physiological measures or anxiety reduction, and no infections occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patient-controlled bag squeeze appears to be a safe and effective analgesia method comparable to caregiver-assisted methods, and demonstrates favorable patient preference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>University Hospital Medical Information Network clinical trials registry, Japan: UMIN000057485</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052007","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}
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