International Journal of Urology最新文献

Objectives: Nocturnal enuresis is common in early childhood. While daytime bladder control typically precedes nighttime continence, the temporal relationship between early daytime bladder control and subsequent bedwetting remains unclear. We investigated whether daytime bladder control status at age 2.5 years-as indicated by diaper use-is associated with bedwetting at age 4.5 years in a Japanese nationwide cohort.

Methods: We analyzed data from the Japanese Longitudinal Survey of Newborns in the 21st Century (2010 cohort). Daytime bladder control was assessed at age 2.5 years through caregiver-reported diaper use, and bedwetting frequency at age 4.5 years through parental questionnaires. Modified Poisson regression estimated risk ratios (RRs), adjusting for birth-related factors, socioeconomic status, daycare attendance, and developmental milestones.

Results: Among 32 168 children, 26 651 (82.8%) still used diapers at 2.5 years. Bedwetting prevalence at 4.5 years was 42.2%: 34.5% in children who achieved daytime bladder control at 2.5 years versus 43.9% in those still using diapers. After multivariable adjustment, incomplete daytime bladder control at 2.5 years was associated with higher bedwetting risk (adjusted RR 1.25; 95% CI, 1.20-1.31). Multinomial regression revealed dose-response relationships: odds ratios 1.41 (95% CI, 1.30-1.52) for "sometimes" and 1.58 (95% CI, 1.42-1.77) for "often" bedwetting.

Conclusions: Daytime bladder control status at 2.5 years was associated with a 25% increased bedwetting risk at 4.5 years. This association likely reflects individual differences in bladder control maturation rather than causal effects. While daytime bladder control may serve as a developmental marker, its validity as an intervention target remains unestablished.

Objective: This collaborative, multi-institutional retrospective study aimed to evaluate whether achieving the radical cystectomy-pentafecta contributes to improved outcomes in patients with muscle-invasive bladder cancer undergoing neoadjuvant chemotherapy followed by robot-assisted radical cystectomy.

Methods: We retrospectively analyzed 195 patients with muscle-invasive bladder cancer who underwent robot-assisted radical cystectomy with intracorporeal urinary diversion at four affiliated institutions. All had a minimum follow-up of 12 months. According to previously established criteria, patients who simultaneously demonstrated (i) negative soft tissue surgical margins, (ii) ≥ 16 lymph node yield, (iii) absence of major complications at 90 days, (iv) absence of urinary diversion-related long-term sequelae, and (v) absence of clinical recurrence in the first year were considered to have achieved the radical cystectomy-pentafecta.

Results: The overall radical cystectomy-pentafecta achievement rate was 46.2% (46.5% in the neoadjuvant chemotherapy group and 45.3% in the no chemotherapy group). In the neoadjuvant chemotherapy group, patients who achieved the radical cystectomy-pentafecta demonstrated significantly better overall survival (p = 0.038), cancer-specific survival (p = 0.009), and recurrence-free survival (p < 0.001) than those who did not.

Conclusions: The radical cystectomy-pentafecta is a valuable tool to assess the quality of robot-assisted radical cystectomy with intracorporeal urinary diversion. Its achievement may be associated with improved outcomes in patients with muscle-invasive bladder cancer undergoing neoadjuvant chemotherapy prior to surgery.

Objectives: Occult tethered cord syndrome is a neurological condition characterized by bladder control difficulties owing to spinal cord tethering. It is often missed on routine magnetic resonance imaging as it lacks typical signs. We investigated whether the Toronto Dysfunctional Voiding Symptom Score can screen occult tethered cord syndrome in children with daytime urinary incontinence.

Methods: We retrospectively analyzed 109 children with daytime urinary incontinence. Based on clinical symptoms and specialized magnetic resonance imaging findings, the children were categorized into two groups: 15 children diagnosed with and 94 children without occult tethered cord syndrome. We used the Mann-Whitney U test to compare the Toronto Dysfunctional Voiding Symptom Score between groups. A diagnosis of occult tethered cord syndrome was confirmed with the presence of a thickened filum terminale on prone-position magnetic resonance imaging and non-responsiveness to anticholinergic medication.

Results: The median Toronto Dysfunctional Voiding Symptom Score was significantly higher in the group with occult tethered cord syndrome (11.0) versus the control group (9.0). Analysis revealed that a cutoff Toronto Dysfunctional Voiding Symptom Score of 10 yielded sensitivity of 80.0% and specificity of 57.4% in identifying occult tethered cord syndrome. Notably, scores < 10 had a negative predictive value of 94.7%, indicating a low probability of occult tethered cord syndrome.

Conclusion: Our study findings suggested that the Toronto Dysfunctional Voiding Symptom Score at the first visit can effectively screen occult tethered cord syndrome in children with daytime urinary incontinence. This finding can potentially streamline the diagnostic process and prevent unnecessary medical investigations.

Retraction: R. Zahran, A. Ghozy, S. S. Elkholy, F. El-Taweel, and M. Abu El-Magd, "Combination Therapy with Melatonin, Stem Cells and Extracellular Vesicles is Effective in Limiting Renal Ischemia-Reperfusion Injury in a Rat Model," International Journal of Urology 27, no. 1 (2020): 1039-1049. https://doi.org/10.1111/iju.14345. The above article, published online on 14 August 2020 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal's Editor-in-Chief Naoya Masumori; the Japanese Urological Association; and John Wiley & Sons Australia, Ltd. A third party reported that images of comet assays in Figure 6 showed evidence of manipulation. An investigation by the publisher found evidence of image manipulation in Figure 1b and Figure 6 as well as evidence of splicing in Figures 5e and 7c. The authors did not respond to an inquiry and request for original data by the publisher. The retraction has been agreed to because the evidence of image manipulation fundamentally compromises the editors' confidence in the results presented. The authors did not respond to the notice regarding the retraction.