Pub Date : 2025-02-06DOI: 10.1097/JU.0000000000004449
Niels V Johnsen
{"title":"Editorial Comment.","authors":"Niels V Johnsen","doi":"10.1097/JU.0000000000004449","DOIUrl":"https://doi.org/10.1097/JU.0000000000004449","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004449"},"PeriodicalIF":5.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1097/JU.0000000000004434
Ross Hengel, Alex Vanni, Brad Erickson, Sean Elliott, Ben Breyer, Jill C Buckley, Josh Broghammer, Bryan Voelzke, Jeremy Myers, Keith Rourke
Purpose: Ideal treatment of lichen sclerosus (LS)-induced penile urethral strictures (PUS) remains elusive. The objective of this study was to compare multi-institutional outcomes of single-stage urethroplasty (SSU) with oral mucosal graft, staged urethroplasty, and perineal urethrostomy (PU) for treatment of LS-induced PUS.
Materials and methods: Multi-institutional analysis was performed at 9 centers on men undergoing SSU, staged urethroplasty, or PU for LS-induced PUS. Meatal strictures (<2 cm), bulbar urethral involvement, and panurethral strictures (>10 cm) were excluded. The primary outcome was recurrence-free status on follow-up assessment. Secondary outcomes included 90-day complications (Clavien ≥ 2), erectile dysfunction, chordee, and urethrocutaneous fistula.
Results: Two hundred thirty-one patients were included with a median stricture length of 5 cm and median follow-up of 53 months among those without stricture recurrence. 1-, 5-, and 10-year stricture-free estimates were 90%, 80%, and 75%, respectively. 55% (127/231) underwent SSU with oral mucosal graft, 19% (44) staged urethroplasty, and 26% (60) underwent PU. On log-rank, there was no identifiable difference in stricture recurrence between techniques (P = .6) with 5-year stricture-free estimates of 82%, 76%, and 75%, respectively. On χ2, there was no significant difference in 90-day complications (7.1% vs 16% vs 8.3%; P = .2), erectile dysfunction (7.1% vs 4.5% vs 3.3%; P = .6), chordee (5.5% vs 6.8% vs 1.7%; P = .4), or urethrocutaneous fistula (2.4% vs 6.8% vs 0%; P = .09). On Cox regression, only obesity (BMI ≥ 35) was associated with stricture recurrence (HR, 2.31, 95% CI, 1.28-4.17; P = .006).
Conclusions: Favorable comparative outcomes confirm SSU as a highly feasible treatment for LS-induced PUS in properly selected patients, especially when considering fewer surgeries required and preservation of an orthotopic meatus.
摘要：硬地衣（LS）致阴茎尿道狭窄的理想治疗方法尚不明确。本研究的目的是比较单阶段尿道成形术（SSU）与口腔黏膜移植（OMG）、阶段尿道成形术和会阴尿道造口术（PU）治疗LS诱导脓液的多机构疗效。方法：对9个中心接受SSU、分期尿道成形术或PU治疗LS性脓肿的男性患者进行多机构分析。排除金属狭窄（10 cm）。主要终点是随访评估的无复发状态。次要结局包括90天并发症（Clavien≥2）、勃起功能障碍、脊索和尿道瘘。结果：231例患者中位狭窄长度为5cm，无狭窄复发的患者中位随访53个月。1年、5年和10年无狭窄估计分别为90%、80%和75%。55%（127/231）患者行SSU伴OMG， 19%（44）分期行尿道成形术，26%（60）行PU。在log-rank上，两种技术之间的狭窄复发率没有明显差异（p=0.6）， 5年无狭窄估计分别为82%、76%和75%。卡方分析显示，90天并发症（7.1% vs. 16% vs. 8.3%;p=0.2）、勃起功能障碍(7.1% vs. 4.5% vs. 3.3%；P =0.6)；vs.1.7% 6.8%;P =0.4)或尿道瘘(2.4% vs. 6.8% vs. 0%；p = 0.09)。Cox回归分析显示，只有肥胖（BMI≥35）与狭窄复发相关(风险比2.31,95%CI 1.28-4.17；p = 0.006)。结论：良好的对比结果证实，在适当选择的患者中，单期尿道成形术是一种高度可行的治疗LS诱导脓液的方法，特别是考虑到所需手术次数减少和保留原位道。
{"title":"Multi-Institutional Analysis of Surgery for Lichen Sclerosus-Induced Penile Urethral Stricture: Establishing Single-Stage Urethroplasty as a Primary Treatment Option.","authors":"Ross Hengel, Alex Vanni, Brad Erickson, Sean Elliott, Ben Breyer, Jill C Buckley, Josh Broghammer, Bryan Voelzke, Jeremy Myers, Keith Rourke","doi":"10.1097/JU.0000000000004434","DOIUrl":"10.1097/JU.0000000000004434","url":null,"abstract":"<p><strong>Purpose: </strong>Ideal treatment of lichen sclerosus (LS)-induced penile urethral strictures (PUS) remains elusive. The objective of this study was to compare multi-institutional outcomes of single-stage urethroplasty (SSU) with oral mucosal graft, staged urethroplasty, and perineal urethrostomy (PU) for treatment of LS-induced PUS.</p><p><strong>Materials and methods: </strong>Multi-institutional analysis was performed at 9 centers on men undergoing SSU, staged urethroplasty, or PU for LS-induced PUS. Meatal strictures (<2 cm), bulbar urethral involvement, and panurethral strictures (>10 cm) were excluded. The primary outcome was recurrence-free status on follow-up assessment. Secondary outcomes included 90-day complications (Clavien ≥ 2), erectile dysfunction, chordee, and urethrocutaneous fistula.</p><p><strong>Results: </strong>Two hundred thirty-one patients were included with a median stricture length of 5 cm and median follow-up of 53 months among those without stricture recurrence. 1-, 5-, and 10-year stricture-free estimates were 90%, 80%, and 75%, respectively. 55% (127/231) underwent SSU with oral mucosal graft, 19% (44) staged urethroplasty, and 26% (60) underwent PU. On log-rank, there was no identifiable difference in stricture recurrence between techniques (<i>P</i> = .6) with 5-year stricture-free estimates of 82%, 76%, and 75%, respectively. On χ<sup>2</sup>, there was no significant difference in 90-day complications (7.1% vs 16% vs 8.3%; <i>P</i> = .2), erectile dysfunction (7.1% vs 4.5% vs 3.3%; <i>P</i> = .6), chordee (5.5% vs 6.8% vs 1.7%; <i>P</i> = .4), or urethrocutaneous fistula (2.4% vs 6.8% vs 0%; <i>P</i> = .09). On Cox regression, only obesity (BMI ≥ 35) was associated with stricture recurrence (HR, 2.31, 95% CI, 1.28-4.17; <i>P</i> = .006).</p><p><strong>Conclusions: </strong>Favorable comparative outcomes confirm SSU as a highly feasible treatment for LS-induced PUS in properly selected patients, especially when considering fewer surgeries required and preservation of an orthotopic meatus.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004434"},"PeriodicalIF":5.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1097/JU.0000000000004443
Niccolo M Passoni, Jonathan C Routh
{"title":"Editorial Comment.","authors":"Niccolo M Passoni, Jonathan C Routh","doi":"10.1097/JU.0000000000004443","DOIUrl":"https://doi.org/10.1097/JU.0000000000004443","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004443"},"PeriodicalIF":5.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1097/JU.0000000000004446
Jin Kyu Kim, Mandy Rickard, Armando Lorenzo
{"title":"Letter: Artificial Intelligence as a Discriminator of Competence in Urological Training: Are We There?","authors":"Jin Kyu Kim, Mandy Rickard, Armando Lorenzo","doi":"10.1097/JU.0000000000004446","DOIUrl":"https://doi.org/10.1097/JU.0000000000004446","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004446"},"PeriodicalIF":5.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1097/JU.0000000000004442
Katelyn Spencer, Amanda F Buchanan
{"title":"Editorial Comment.","authors":"Katelyn Spencer, Amanda F Buchanan","doi":"10.1097/JU.0000000000004442","DOIUrl":"https://doi.org/10.1097/JU.0000000000004442","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004442"},"PeriodicalIF":5.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1097/JU.0000000000004440
Weizhuo Wang, Chuchu Gao, Kai Fu
{"title":"Letter: Incidence of Erectile Dysfunction and Testosterone Deficiency in Testicular Cancer Survivors.","authors":"Weizhuo Wang, Chuchu Gao, Kai Fu","doi":"10.1097/JU.0000000000004440","DOIUrl":"https://doi.org/10.1097/JU.0000000000004440","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004440"},"PeriodicalIF":5.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-30DOI: 10.1097/JU.0000000000004302
Shane Kronstedt, Eric A Singer
{"title":"Editorial Comment.","authors":"Shane Kronstedt, Eric A Singer","doi":"10.1097/JU.0000000000004302","DOIUrl":"10.1097/JU.0000000000004302","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"236-237"},"PeriodicalIF":5.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-11-07DOI: 10.1097/JU.0000000000004307
Meera R Chappidi, Daniel W Lin, Claire M de la Calle
{"title":"Editorial Comment.","authors":"Meera R Chappidi, Daniel W Lin, Claire M de la Calle","doi":"10.1097/JU.0000000000004307","DOIUrl":"10.1097/JU.0000000000004307","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"190-191"},"PeriodicalIF":5.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-23DOI: 10.1097/JU.0000000000004286
Sean P Elliott
{"title":"Trauma, and Genital and Urethral Reconstruction.","authors":"Sean P Elliott","doi":"10.1097/JU.0000000000004286","DOIUrl":"https://doi.org/10.1097/JU.0000000000004286","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":"213 2","pages":"261-262"},"PeriodicalIF":5.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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