Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.033
Valerie C Nemov, Zoran J Pavlovic, Anthony N Imudia
{"title":"Reply to Editorial Comment on \"Predictive Value of Teratospermia During Initial Sperm Analysis on the Success of Intrauterine Insemination Cycles\".","authors":"Valerie C Nemov, Zoran J Pavlovic, Anthony N Imudia","doi":"10.1016/j.urology.2024.09.033","DOIUrl":"https://doi.org/10.1016/j.urology.2024.09.033","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296593","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.029
Vanessa Ogbuji, D 'Andre Marquez Gomez, Irasema Concepcion Paster, Von Marie Torres Irizarry, Kyle McCormick, Leslie K Dennis, Alejandro Recio-Boiles, Juan Chipollini
We performed a narrative review evaluating the influence of race and socioeconomic status for penile cancer patients based on region. We found higher incidence in underdeveloped nations. Globally, HPV-associated tumors are more prevalent, particularly in areas with high HPV and HIV infection. Socioeconomic determinants exacerbated these disparities. Similarly, in the United States, disparities were notable among racial and ethnic groups, with black men having worse survival. Understanding sociodemographic differences may help mitigate disparities by improving access to care with targeted interventions including education on risk factors and HPV vaccination to reduce penile cancer burden in vulnerable parts of the world.
我们进行了一项叙述性综述,评估了种族和社会经济地位对不同地区阴茎癌患者的影响。我们发现欠发达国家的发病率较高。在全球范围内,HPV 相关肿瘤的发病率更高,尤其是在 HPV 和 HIV 感染率较高的地区。社会经济因素加剧了这些差异。同样,在美国,种族和族裔群体之间的差异也很明显,黑人男性的存活率更低。了解社会人口学差异有助于减少差异,通过有针对性的干预措施(包括风险因素教育和HPV疫苗接种)改善获得护理的机会,从而减少世界上脆弱地区的阴茎癌负担。
{"title":"Global Burden of Penile Cancer: A Review of Health Disparities for a Rare Disease.","authors":"Vanessa Ogbuji, D 'Andre Marquez Gomez, Irasema Concepcion Paster, Von Marie Torres Irizarry, Kyle McCormick, Leslie K Dennis, Alejandro Recio-Boiles, Juan Chipollini","doi":"10.1016/j.urology.2024.09.029","DOIUrl":"10.1016/j.urology.2024.09.029","url":null,"abstract":"<p><p>We performed a narrative review evaluating the influence of race and socioeconomic status for penile cancer patients based on region. We found higher incidence in underdeveloped nations. Globally, HPV-associated tumors are more prevalent, particularly in areas with high HPV and HIV infection. Socioeconomic determinants exacerbated these disparities. Similarly, in the United States, disparities were notable among racial and ethnic groups, with black men having worse survival. Understanding sociodemographic differences may help mitigate disparities by improving access to care with targeted interventions including education on risk factors and HPV vaccination to reduce penile cancer burden in vulnerable parts of the world.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296581","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}
Objective: To validate the value of the LSE classification and scoring system in predicting surgical outcomes for male anterior urethral stricture cases.
Methods: A retrospective review was conducted on 566 patients who underwent urethroplasty between August 2004 and March 2022. After excluding pelvic fracture urethral injury and non-stricture diseases and incomplete data, 358 patients were classified according to the LSE classification system, and both U score and LSE score were calculated. We investigated the relationship between LSE score and U score in predicting recurrence. Recurrence was defined as any instance requiring re-intervention. To identify factors contributing to recurrence, logistic regression analysis was performed on the LSE score and variables not included in the scoring system.
Results: The breakdown of S, and E components showed external trauma as the most common cause of strictures, with proximal bulbar urethra being the most common segment. Significant associations were observed between stricture etiology and segment, as well as between surgical technique and segment. A strong correlation (r = 0.73) was found between U score and LSE score, with no significant difference in predicting recurrence between the 2 scores. Surgical complexity differed significantly between LSE score groups, but surgical duration did not. Patients with LSE <7 showed a better recurrence rate in Kaplan-Meier analysis. Multivariate logistic analysis identified LSE ≥7 as an independent risk factor for recurrence.
Conclusion: The LSE classification system and scoring system demonstrate validity in characterizing anterior urethral strictures and predicting surgical outcomes.
{"title":"Validation Study of the LSE Classification and Scoring System in Comparison With U-Score.","authors":"Tadashi Tabei, Akio Horiguchi, Masayuki Shinchi, Yusuke Hirano, Kenichiro Ojima, Keiichi Ito, Ryuichi Azuma","doi":"10.1016/j.urology.2024.09.022","DOIUrl":"10.1016/j.urology.2024.09.022","url":null,"abstract":"<p><strong>Objective: </strong>To validate the value of the LSE classification and scoring system in predicting surgical outcomes for male anterior urethral stricture cases.</p><p><strong>Methods: </strong>A retrospective review was conducted on 566 patients who underwent urethroplasty between August 2004 and March 2022. After excluding pelvic fracture urethral injury and non-stricture diseases and incomplete data, 358 patients were classified according to the LSE classification system, and both U score and LSE score were calculated. We investigated the relationship between LSE score and U score in predicting recurrence. Recurrence was defined as any instance requiring re-intervention. To identify factors contributing to recurrence, logistic regression analysis was performed on the LSE score and variables not included in the scoring system.</p><p><strong>Results: </strong>The breakdown of S, and E components showed external trauma as the most common cause of strictures, with proximal bulbar urethra being the most common segment. Significant associations were observed between stricture etiology and segment, as well as between surgical technique and segment. A strong correlation (r = 0.73) was found between U score and LSE score, with no significant difference in predicting recurrence between the 2 scores. Surgical complexity differed significantly between LSE score groups, but surgical duration did not. Patients with LSE <7 showed a better recurrence rate in Kaplan-Meier analysis. Multivariate logistic analysis identified LSE ≥7 as an independent risk factor for recurrence.</p><p><strong>Conclusion: </strong>The LSE classification system and scoring system demonstrate validity in characterizing anterior urethral strictures and predicting surgical outcomes.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296596","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.034
Geehan Suleyman, Banna Hussain, Ali A Dabaja
{"title":"Letter to the Editor: Use of Catheterization Algorithms to Manage Acute Urinary Retention; What is the Evidence?","authors":"Geehan Suleyman, Banna Hussain, Ali A Dabaja","doi":"10.1016/j.urology.2024.09.034","DOIUrl":"https://doi.org/10.1016/j.urology.2024.09.034","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296586","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.030
Kamran P Sajadi
{"title":"Editorial Comment on \"External Validation Demonstrates Machine Learning Models Outperform Human Experts in Prediction of Objective and Patient-reported Overactive Bladder Treatment Outcomes\".","authors":"Kamran P Sajadi","doi":"10.1016/j.urology.2024.09.030","DOIUrl":"10.1016/j.urology.2024.09.030","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296574","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.013
Tariq Abbas, Sibel Tiryaki, Ali Tekin, Nicolas Fernandez, Mohamed Fawzy, Ibrahim Ulman, Alp Numanoglu, Ahmed Hadidi, Mansour Ali, Iqbal Hassan, Muhammad Chowdhury
Objective: To objectively evaluate technical skill acquisition in hypospadias repair procedures during surgical training using noninvasive wearable sensor technology.
Methods: We combined subjective video evaluations with objective electromyography (EMG) measurements in a hands-on hypospadias training course. Surgeons wore wireless EMG and accelerometer sensors on their dominant hand while performing tasks on ex-vivo cadaveric calf penises. The study focused on 4 skills as follows: urethral mobilization, dorsal inlay graft harvest/implantation, meatal-based flap urethroplasty, and dorsal plication. Machine learning techniques analyzed muscle activation patterns and attributes for assessing surgical precision.
Results: The course included 18 participants (10 female, 8 males; average age 40.18 ± 8.46 years) categorized as novice (n = 10, <3 years' experience), intermediate (n = 5, 3-5 years), and expert (n = 3, >5 years). Video evaluations did not reveal significant differences due to short-term training. However, EMG measurements showed significant reductions in average EMG power, total time, dominant frequency, and cumulative muscle workload after training. Additionally, the mean power spectral density of the EMG signal decreased notably post-training.
Conclusion: This study presents a structured approach for hypospadias training and highlights the effectiveness of wearable sensor technology for objective skill assessment. While video evaluations did not detect significant changes, EMG data provided measurable differences in skill acquisition, suggesting that wearable sensors could enhance objective evaluations of surgical proficiency in residency programs.
{"title":"Hypospadias Reconstruction Training: Development of an Ex-Vivo Model for Objective Evaluation of Surgical Skills.","authors":"Tariq Abbas, Sibel Tiryaki, Ali Tekin, Nicolas Fernandez, Mohamed Fawzy, Ibrahim Ulman, Alp Numanoglu, Ahmed Hadidi, Mansour Ali, Iqbal Hassan, Muhammad Chowdhury","doi":"10.1016/j.urology.2024.09.013","DOIUrl":"10.1016/j.urology.2024.09.013","url":null,"abstract":"<p><strong>Objective: </strong>To objectively evaluate technical skill acquisition in hypospadias repair procedures during surgical training using noninvasive wearable sensor technology.</p><p><strong>Methods: </strong>We combined subjective video evaluations with objective electromyography (EMG) measurements in a hands-on hypospadias training course. Surgeons wore wireless EMG and accelerometer sensors on their dominant hand while performing tasks on ex-vivo cadaveric calf penises. The study focused on 4 skills as follows: urethral mobilization, dorsal inlay graft harvest/implantation, meatal-based flap urethroplasty, and dorsal plication. Machine learning techniques analyzed muscle activation patterns and attributes for assessing surgical precision.</p><p><strong>Results: </strong>The course included 18 participants (10 female, 8 males; average age 40.18 ± 8.46 years) categorized as novice (n = 10, <3 years' experience), intermediate (n = 5, 3-5 years), and expert (n = 3, >5 years). Video evaluations did not reveal significant differences due to short-term training. However, EMG measurements showed significant reductions in average EMG power, total time, dominant frequency, and cumulative muscle workload after training. Additionally, the mean power spectral density of the EMG signal decreased notably post-training.</p><p><strong>Conclusion: </strong>This study presents a structured approach for hypospadias training and highlights the effectiveness of wearable sensor technology for objective skill assessment. While video evaluations did not detect significant changes, EMG data provided measurable differences in skill acquisition, suggesting that wearable sensors could enhance objective evaluations of surgical proficiency in residency programs.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296583","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.032
Mang L Chen
{"title":"Editorial Comment on \"Complication Rates of Penile Prostheses After Phalloplasty in Transmen: A Meta-analysis\".","authors":"Mang L Chen","doi":"10.1016/j.urology.2024.09.032","DOIUrl":"10.1016/j.urology.2024.09.032","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296572","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.028
Michael D Gross, Rebecca A Campbell
{"title":"Editorial Comment on \"Preoperative Computed Tomography Imaging Accurately Identifies Adrenal Gland Involvement In Patients With Renal Masses\".","authors":"Michael D Gross, Rebecca A Campbell","doi":"10.1016/j.urology.2024.09.028","DOIUrl":"https://doi.org/10.1016/j.urology.2024.09.028","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296575","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.012
James T Rague, Josephine Hirsch, Theresa Meyer, Courtney Streur, Ilina Rosoklija, Stephanie Kielb, Earl Y Cheng, Diana K Bowen, Elizabeth B Yerkes, David I Chu
Objective: To explore the perspectives of young adult males with spina bifida (SB) on their fertility potential and parenthood.
Methods: Semi-structured qualitative interviews were conducted between 2/2021 and 5/2021 with men ≥18 years of age with SB on perspectives on fertility potential and parenthood. Demographic and clinical characteristics were obtained from a survey and chart review. Interviews were transcribed verbatim and assessed through conventional content analysis framework.
Results: Of 30 eligible individuals approached, 20 agreed to participate. Median age was 22.5 years (range 18-29), and 80% had myelomeningocele. Most reported not being in a relationship (14/20, 70%), not being currently sexually active (13/20, 65%), and no participant reported a history of paternity. Many reported a desire for future fertility. Uncertainty and areas of concern were identified regarding their physiologic and psychosocial ability to be a parent. Perceived barriers to achieving parenthood included (1) uncertainty around fertility potential and the hereditary nature of SB; and (2) concerns with being a parent and raising a child. Facilitators to help overcome uncertainty, such as gaining knowledge on fertility testing options and understanding means of preventing neural tube defects, were identified. Participants expressed the importance of strong peer and family support to help overcome challenges related to parenthood.
Conclusion: Men with SB are interested in future fertility, yet uncertainty exists around the physiologic and psychosocial ability to be a parent. Facilitators to help overcome uncertainty and concerns should be a focus of patient counseling around future fertility with young men with SB.
{"title":"Perspectives of Young Men With Spina Bifida on Fertility Potential and Future Parenthood.","authors":"James T Rague, Josephine Hirsch, Theresa Meyer, Courtney Streur, Ilina Rosoklija, Stephanie Kielb, Earl Y Cheng, Diana K Bowen, Elizabeth B Yerkes, David I Chu","doi":"10.1016/j.urology.2024.09.012","DOIUrl":"10.1016/j.urology.2024.09.012","url":null,"abstract":"<p><strong>Objective: </strong>To explore the perspectives of young adult males with spina bifida (SB) on their fertility potential and parenthood.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted between 2/2021 and 5/2021 with men ≥18 years of age with SB on perspectives on fertility potential and parenthood. Demographic and clinical characteristics were obtained from a survey and chart review. Interviews were transcribed verbatim and assessed through conventional content analysis framework.</p><p><strong>Results: </strong>Of 30 eligible individuals approached, 20 agreed to participate. Median age was 22.5 years (range 18-29), and 80% had myelomeningocele. Most reported not being in a relationship (14/20, 70%), not being currently sexually active (13/20, 65%), and no participant reported a history of paternity. Many reported a desire for future fertility. Uncertainty and areas of concern were identified regarding their physiologic and psychosocial ability to be a parent. Perceived barriers to achieving parenthood included (1) uncertainty around fertility potential and the hereditary nature of SB; and (2) concerns with being a parent and raising a child. Facilitators to help overcome uncertainty, such as gaining knowledge on fertility testing options and understanding means of preventing neural tube defects, were identified. Participants expressed the importance of strong peer and family support to help overcome challenges related to parenthood.</p><p><strong>Conclusion: </strong>Men with SB are interested in future fertility, yet uncertainty exists around the physiologic and psychosocial ability to be a parent. Facilitators to help overcome uncertainty and concerns should be a focus of patient counseling around future fertility with young men with SB.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296591","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}
Pub Date : 2024-09-19DOI: 10.1016/j.urology.2024.09.031
Hazem Elmansy
{"title":"Editorial Comment on \"Clinical Outcomes in Patients with Hypocontractile Bladders Undergoing Holmium Laser Enucleation of the Prostate\".","authors":"Hazem Elmansy","doi":"10.1016/j.urology.2024.09.031","DOIUrl":"https://doi.org/10.1016/j.urology.2024.09.031","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296571","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}