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Salvage Artificial Urinary Sphincter Placement After Sling Failure: Long-term Outcomes and Institutional Predictors in a Population-based Cohort 悬吊失败后补救性人工尿道括约肌置入：基于人群队列的长期结果和制度预测因素。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2025-12-05 DOI: 10.1016/j.urology.2025.11.243

Behzad Abbasi , Nizar Hakam , Mikołaj Frankiewicz , Philip W. Chu , Marvin N. Carlisle , Kevin D. Li , Alejandro A. Jimenez , Lynn Leng , Michael J. Sadighian , John M. Myrga , Lindsay A. Hampson , Benjamin N. Breyer

Objectives

To characterize transitions from sling to artificial urinary sphincter (AUS) and identify contributing factors.

Methods

We analyzed longitudinal ambulatory surgery records from California’s Department of Health Care Access and Information (2007–2016). Adult male California residents who underwent index AUS or sling placement were identified. Primary outcome was time to transition from sling to AUS. A multivariable Cox proportional hazards model was used to identify factors associated with salvage AUS placement among sling patients. Another univariable model compared the long-term AUS failure risk in salvage versus primary AUS recipients.

Results

Our cohort comprised 1,400 sling patients from 154 facilities, with a median follow-up of 3.7 years (IQR, 1.3–5.2 years). At eight years, 20% of sling recipients required salvage AUS. In the multivariable model, a facility’s higher annual AUS caseload (aHR 1.59, 95% CI 1.01–2.49) and greater patient travel distance (aHR 1.19 per 50-mile increase, 95% CI 1.00–1.40) were associated with increased likelihood of salvage AUS placement. Conversely, a high sling volume at the index center was associated with a reduced risk (aHR 0.57, 95% CI 0.38–0.84). Salvage AUS showed durability comparable to that of primary AUS (HR 0.79, 95% CI 0.55–1.13).

Conclusions

One in five sling recipients ultimately requires salvage AUS. Salvage AUS had a similar success rate to that of primary AUS. Institutional experience and geographic access influence reoperation trajectories, underscoring the importance of careful patient selection and counseling.

目的：描述从吊带到人工尿道括约肌（AUS）的转变，并确定影响因素。方法：我们分析了加州卫生保健获取和信息部门（2007-2016）的纵向门诊手术记录。加州成年男性居民接受了指数AUS或吊带放置。主要观察指标为从sling过渡到AUS的时间。采用多变量Cox比例风险模型来确定吊带患者放置救助性AUS的相关因素。另一个单变量模型比较了救助接受者和初次接受者的长期AUS失效风险。结果：我们的队列包括来自154家机构的1400名吊带患者，中位随访3.7年（IQR, 1.3-5.2年）。在8年时，20%的吊索接受者需要救助AUS。在多变量模型中，设施较高的年度AUS病例量（aHR 1.59, 95% CI 1.01-2.49）和较大的患者旅行距离（aHR 1.19每50英里增加，95% CI 1.00-1.40）与补救性AUS放置的可能性增加相关。相反，指数中心的高吊带量与风险降低相关（aHR 0.57, 95% CI 0.38-0.84）。补救性AUS的耐久性与原发性AUS相当（HR 0.79, 95% CI 0.55-1.13）。结论：五分之一的吊索受者最终需要补救性AUS。救助性AUS的成功率与原发性AUS相似。机构经验和地理位置影响再手术轨迹，强调了仔细选择患者和咨询的重要性。

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引用次数: 0

Performance of a Standardized Retrograde Urethrogram to Optimize Length, Segment, Etiology (LSE) Anterior Urethral Stricture Disease Classification and Staging 标准化逆行尿道造影优化LSE前尿道狭窄疾病分类和分期的效果

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2025-12-10 DOI: 10.1016/j.urology.2025.11.247

Kenan B. Ashouri, Alexandria M. Hertz, Bradley A. Erickson

引用次数: 0

Editorial Comment on “Variability in Cystatin C- and Creatinine-estimated Glomerular Filtration Rate in Adults With Spina Bifida” 编辑评论：成人脊柱裂患者胱抑素C和肌酐估计GFR的变异性。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2026-01-14 DOI: 10.1016/j.urology.2026.01.006

Glenn T. Werneburg

引用次数: 0

Editorial Comment on “Outcomes of Patients With Localized Renal Cell Carcinoma on Immunosuppression Following Solid Organ Transplantation” 对“局部肾细胞癌患者实体器官移植后免疫抑制的结果”的评论。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1016/j.urology.2026.01.003

Kassandra Dindinger-Hill, Alejandro Sanchez

引用次数: 0

Clinical Outcomes Comparing Mini Versus Standard PCNL Without Postoperative Nephrostomy Tube: A Multi-institutional Randomized Controlled Trial From the EDGE Consortium 临床结果比较Mini和标准PCNL术后无肾造瘘管：来自EDGE联盟的多机构随机对照试验。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2025-11-13 DOI: 10.1016/j.urology.2025.11.229

Tyler Sheetz , Jamie L. Finegan , Sri Sivalingam , Ben H. Chew , Connor M. Forbes , Ryan F. Paterson , Ryan S. Hsi , Nicole L. Miller , Bodo E. Knudsen , Michael W. Sourial , Matthew S. Lee , Victor K.F. Wong , Catherine Bresee , Kevin M. Wymer , Roger L. Sur , Manoj Monga , Seth K. Bechis

Objective

To investigate whether a smaller tract size for percutaneous nephrolithotomy (PCNL) may result in fewer complications including blood loss, while retaining similar stone-free rates and operative time, utilizing a modern approach without postoperative nephrostomy tube.

Methods

We performed a randomized controlled trial at five participating EDGE institutions in North America. Patients were randomized to receive 17.5Fr miniature tract vs 30Fr standard sized tract for PCNL without postoperative nephrostomy tubes.

Results

Demographic variables were similar. Mean decrease in hemoglobin was 1.84 g/dL for standard and 1.67 g/dL for mini (p = .654), with similar blood transfusion rates. Differences in stone-free rates (71% standard vs 77% mini) emergency room visits (13% vs 23%), additional procedural interventions (9% vs 3%), and intrarenal pressure measurements were not statistically significant. Mean pain scores in the post-anesthesia care unit were low in both groups (2.53 standard vs 1.88 mini, p = .440). Clavien-Dindo complication rates were 14% for standard and 15% for mini (p = .593). There were 11% and 5% of patients in standard and mini groups who experienced at least 2/4 systemic inflammatory response syndrome (SIRS) criteria (p = .370).

Conclusion

Results from a multi-institutional randomized controlled trial evaluating mini versus standard PCNL without postoperative nephrostomy tubes indicate no statistically significant differences in intraoperative, postoperative, or stone-free outcomes. Surgeons should be empowered to utilize the PCNL tract size that best meets the needs of their patient, institution, and practice.

(a)目的：探讨经皮肾镜取石术（PCNL）中更小的尿路是否可以减少包括失血在内的并发症，同时使用不需要术后肾造口管的现代入路保持相似的结石清除率和手术时间。(b)方法：我们在北美五个参与EDGE的机构进行了一项随机对照试验。患者被随机分为17.5Fr微型道和30Fr标准道，用于无术后肾造口管的PCNL。(c)结果：人口统计学变量相似。输血率相似，标准组血红蛋白平均下降1.84 g/dL，迷你组血红蛋白平均下降1.67 g/dL （p=0.654）。无结石率（71%标准vs 77%迷你）急诊就诊（13% vs 23%）、额外手术干预（9% vs 3%）和肾内压测量的差异无统计学意义。两组患者麻醉后护理单元的平均疼痛评分均较低（2.53标准对1.88迷你，p=0.440）。标准组Clavien-Dindo并发症发生率为14%，迷你组为15% （p=0.593）。标准组和迷你组中分别有11%和5%的患者经历了至少2/4的系统性炎症反应综合征（SIRS）标准（p=0.370）。(d)结论：一项多机构随机对照试验评估迷你与标准PCNL的结果显示，术中、术后或无结石结局无统计学差异。外科医生应被授权使用最能满足患者、机构和实践需要的PCNL束大小。

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引用次数: 0

Editorial Comment on “Erectile Dysfunction as a Predictor of Subclinical Atherosclerosis: A Community Health Assessment Using Coronary Calcium Scoring in Underserved Cleveland, Ohio” “勃起功能障碍作为亚临床动脉粥样硬化的预测因子：在服务不足的俄亥俄州克利夫兰使用冠状动脉钙评分进行社区健康评估”的社论评论。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2025-12-04 DOI: 10.1016/j.urology.2025.11.252

Ashley N. Matthew , Martin M. Miner

引用次数: 0

Editorial Comment on “Clinical Outcomes Comparing Mini Versus Standard PCNL Without Postoperative Nephrostomy Tube: A Multi-institutional Randomized Controlled Trial From the EDGE Consortium” 《EDGE联盟的一项多机构随机对照试验：比较Mini与标准PCNL无术后肾造瘘管的临床结果》的社论评论。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2025-12-12 DOI: 10.1016/j.urology.2025.12.009

Bradley F. Schwartz

引用次数: 0

Editorial Comment on “Salvage Artificial Urinary Sphincter Placement After Sling Failure: Long-term Outcomes and Institutional Predictors in a Population-based Cohort” 关于“吊带失败后补助性人工尿道括约肌置入：基于人群队列的长期结果和制度预测因素”的社论评论。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1016/j.urology.2025.12.040

Grace Kennedy , Hiren V. Patel

引用次数: 0

Editorial Comment on “Ultrasound Diagnostic Features and Management of Torsion-detorsion” “扭扭扭扭的超声诊断特征和处理”社论评论。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1016/j.urology.2025.12.041

Ari Spellman, Jeffrey Stock

引用次数: 0

Reply to Editorial Comment on “Clinical Outcomes Comparing Mini Versus Standard PCNL Without Postoperative Nephrostomy Tube: A Multi-institutional Randomized Controlled Trial From the EDGE Consortium 对“Mini与标准PCNL无术后肾造瘘管的临床结果比较：一项来自EDGE联盟的多机构随机对照试验”社论评论的回应。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1016/j.urology.2026.01.011

引用次数: 0

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