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Editorial Comment on “Absence of Race/Ethnicity Reporting in Clinical Trials of True Minimally Invasive Surgical Therapies for the Treatment of Benign Prostatic Hyperplasia” 关于 "治疗良性前列腺增生症的真正微创手术疗法临床试验中缺乏种族/族裔报告 "的编辑评论。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.10.064

Walter Rayford

引用次数: 0

Midterm Follow-up of Electrofulguration for Vesicular Cystitis in Women With Recurrent Urinary Tract Infections 复发性尿路感染妇女膀胱炎电凝治疗的中期随访。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.10.072

Tze-Chen Chao , Alana L. Christie , Feras Alhalabi , Philippe E. Zimmern

Objective

To report the midterm outcomes of women with symptomatic recurrent urinary tract infections (RUTIs) with findings of vesicular cystitis (VC) on cystoscopy treated with bladder electrofulguration (EF) and to identify factors affecting successful treatment outcome.

Methods

Following Institutional Review Board approval, a prospectively collected long-term database of women with RUTI and VC treated with EF was retrospectively reviewed. Patients were divided into two groups based on the associated presence of urinary obstruction (“obstructed group”) or not. Follow-up included an office cystoscopy 6 months after EF. The primary outcome evaluated was rate of urinary tract infections (UTIs) recurrences over time.

Results

From 2010 to 2023, 50 women met all study criteria, with 94% being postmenopausal. Overall, the 3-year UTI-free survival from repeat fulguration was 71.4% (95% CI, 54.4-83.0). Kaplan-Meier analysis showed that patients with obstruction had a higher 3-year survival of no UTI recurrence (40.3%; 95% CI: 18.2, 61.7) than patients without obstruction (20.8%; 95% CI: 6.2, 41.4], P = .0085).

Conclusion

Over two-thirds of women with VC and symptomatic UTI did not need a second EF or daily antibiotic prophylaxis after the initial EF. Those with VC related to bladder outlet obstruction experienced less RUTIs and a longer time to a repeated EF.

目的报告膀胱镜检查发现水泡性膀胱炎（VC）的无症状复发性尿路感染（RUTI）女性患者接受膀胱电凝（EF）治疗的中期疗效，并确定影响成功治疗结果的因素：方法：在获得 IRB 批准后，我们对前瞻性收集的长期数据库进行了回顾性审查，该数据库收录了接受 EF 治疗的 RUTI 和 VC 女性患者。根据是否伴有尿路梗阻（"梗阻组"）将患者分为两组。随访包括在超频治疗后六个月进行诊室膀胱镜检查。评估的主要结果是一段时间内UTI的复发率：从 2010 年到 2023 年，共有 50 名女性符合所有研究标准，其中 94% 为绝经后女性。总体而言，从重复充盈到无 UTI 的三年生存率为 71.4%（95% CI，54.4 至 83.0）。Kaplan-Meier 分析显示，有梗阻的患者 3 年无 UTI 复发的生存率（40.3%；95% CI：18.2，61.7）高于无梗阻的患者（20.8%；95% CI：6.2，41.4]，P = 0.0085）：超过三分之二的膀胱直肠癌和无症状UTI女性患者在首次超滤后无需进行第二次超滤或每日使用抗生素预防。与膀胱出口梗阻有关的输尿管梗阻患者发生尿路感染的次数较少，而重复使用超滤的时间较长。

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引用次数: 0

Editorial Comment on “Gender Differences in the Adoption and Utilization of Robotic-assisted Laparoscopic Surgery (RALS) Among Practicing Urologists: A Study of American Board of Urology Case Logs From 2012-2022” 关于 "泌尿外科执业医师采用和使用机器人辅助腹腔镜手术 (RALS) 的性别差异：2012-2022年美国泌尿外科委员会病例记录研究"。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.021

Sydney Strup , Andrew Harris

引用次数: 0

Editorial Comment on “PSMA PET-targeted Biopsy for Prostate Cancer Diagnosis: Initial Experience From a Multicenter Cohort” 关于 "用于前列腺癌诊断的 PSMA PET 靶向活检：来自多中心队列的初步经验 "的编辑评论。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.037

Samuel C. Haywood

引用次数: 0

Reply to Editorial Comment on “Five-year Oncologic Outcomes Following Primary Partial Gland Cryo-ablation Prospective Cohort Study of Men With Intermediate-risk Prostate Cancer” 编辑评论："高质量的前瞻性观察研究是否能使基础治疗免于进行 RCT？

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.041

Herbert Lepor

引用次数: 0

Reply to Editorial Comment on “Indwelling Urological Device Biofilm Composition and Characteristics in the Presence and Absence of Infection” 回复“有无感染情况下留置泌尿系统装置生物膜的组成和特性”社论评论。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.049

Glenn T. Werneburg, Sandip P. Vasavada, Aaron W. Miller

引用次数: 0

Same-day Discharge Following Holmium Laser Enucleation of the Prostate Under Spinal Anesthesia: A Propensity Score Matched Comparison With General Anesthesia 脊髓麻醉下钬激光前列腺摘除术后同日出院：倾向评分与全身麻醉相匹配。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.058

Daniela A. Haehn , Ryan M. Chadha , Steven B. Porter , Ram A. Pathak , Timothy D. Lyon , Alex P. Hochwald , Chandler D. Dora

Objective

To determine if using spinal anesthesia (SA) for holmium laser enucleation of the prostate (HoLEP) impacted the ability to perform same-day discharge (SDD) compared to a prostate volume-matched cohort undergoing HoLEP under general anesthesia (GA).

Methods

From January 1, 2021 to March 28, 2024, 995 men underwent HoLEP by a single surgeon. Three hundred eleven were identified who had SA and a recorded preoperative prostate volume. Propensity score matching based on prostate volume was performed with the remaining cohort who received GA in a 1:1 ratio. The primary outcome was rate of SDD.

Results

When comparing SDD between the two groups, 84% of SA patients had SDD compared to 74% of GA patients (P-value .002). The operative time for SA was significantly shorter than GA (89 vs 101 minutes P-value <.001). The total operating room time (wheels-in to wheels-out) including anesthesia induction for SA was significantly shorter than GA (119 vs 128 minutes P-value .0003). There were no significant differences in early catheter reinsertion, emergency department visits, complications, or postoperative serum prostate-specific antigen measured at 3 months.

Conclusion

Utilizing SA for HoLEP did not preclude SDD compared to a prostate volume-matched cohort who underwent HoLEP under GA. In fact, SDD were higher in the SA cohort without a corresponding increase in emergency department visits or catheter reinsertion.

目的：确定与前列腺体积匹配的全麻（GA）下HoLEP患者相比，脊髓麻醉（SA）下钬激光前列腺摘除（HoLEP）是否影响当日出院（SDD）的能力。方法：从2021年1月1日至2024年3月28日，995名男性接受了同一位外科医生的HoLEP。311名患者接受了脊髓麻醉并记录了术前前列腺体积。根据前列腺体积进行倾向评分匹配，其余接受全身麻醉的队列按1:1的比例进行匹配。主要观察指标为SDD发生率。结果：比较两组SDD时，84%的SA患者有SDD，而74%的GA患者有SDD （p值0.002）。SA的手术时间明显短于GA（89分钟vs 101分钟）。结论：与前列腺体积匹配的在GA下接受HoLEP的队列相比，使用SA治疗HoLEP并不排除SDD。事实上，SA组的SDD更高，但没有相应的ED就诊或导管重新插入的增加。

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引用次数: 0

Can Female Voiding Dysfunction Be Predicted Using a Questionnaire? 女性排尿功能障碍能否通过问卷调查来预测？

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.020

Victoria A. Buckley , Anna Rosamilia , Joseph K. Lee

Objective

To evaluate symptoms using the modified International Prostate Symptoms Score (wIPSS) questionnaire and clinical factors that could indicate objective voiding dysfunction (VD) in women.

Methods

One thousand eighty-three women who underwent urodynamic assessment were retrospectively analyzed. The primary outcome was objective VD. Two definitions were utilized; VD1 defined VD as maximum flow rate <10th centile on the Liverpool nomogram, while VD2 defined VD as Qmax ≤15 mL/s and PVR ≥100 mL. Associations of potential explanatory variables with VD were assessed by standard bivariate testing. Classification and Regression Tree analyses were conducted to assess the discriminatory power of explanatory variables for VD.

Results

The prevalence of objective VD depended on the definition used (VD1-30.9% vs VD2-5.8%), as did the median wIPSS score (VD1-15, interquartile range (IQR) 10-20 vs VD2–12.5, IQR 10.3-22.8). Age, menopausal status, previous pelvic floor surgery, current degree of anterior/apical prolapse, a medical history of diabetes or neurological disease, the wIPSS score, as well as the wIPSS with additional items were associated with VD. CART analysis revealed the questions regarding force of stream (FOS) and hesitancy were the strongest predictors for VD.

Conclusion

Rates of objective VD depend on the definition used. VD was associated with the overall wIPSS score, and the additional questions of hesitancy and FOS, which proved to be the most powerful predictors. This modified wIPSS may be a useful tool in screening for the absence of objective VD.

Brief Summary

Can we use a non-invasive screening tool to evaluate for female VD?

目的：使用改良的国际前列腺症状评分表（wIPSS）评估症状，并评估可能表明女性客观前列腺增生的临床因素：使用改良的国际前列腺症状评分（wIPSS）问卷对症状进行评估，并评估可提示女性客观VD的临床因素。方法：对接受尿动力学评估的1083名女性进行回顾性分析。主要结果是客观 VD。采用了两种定义：VD1 将 VD 定义为利物浦提名图上第 th 百分位数的最大流速，而 VD2 将 VD 定义为 Qmax ≤ 15ml/s 和 PVR ≥ 100ml。潜在解释变量与 VD 的关系通过标准双变量检验进行评估。进行了分类和回归树（CART）分析，以评估解释变量对 VD 的判别能力：结果：客观 VD 的患病率取决于所使用的定义（VD1-30.9% vs. VD2-5.8%）以及 wIPSS 的中位数评分（VD1-15，IQR 10-20 vs. VD2-12.5，IQR 10.3-22.8）。年龄、绝经状态、既往盆底手术、目前的前脱垂/脱肛程度、糖尿病或神经系统疾病病史、wIPSS 评分以及带有附加项目的 wIPSS 均与 VD 相关。CART分析表明，有关流力（FOS）和犹豫不决的问题是预测VD的最强指标：结论：客观 VD 率取决于所使用的定义。VD 与 wIPSS 总分以及犹豫不决和 FOS 这两个附加问题有关，而这两个问题被证明是最有力的预测因素。简而言之：我们能否使用无创筛查工具来评估女性排尿功能障碍？

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引用次数: 0

Presentation of Acute Flank Pain in a Young Woman: Breaking the Mold in Emergency Diagnosis 一位年轻女性急性侧腹疼痛的表现：打破常规的急诊诊断。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.11.050

Angel Garrido Urincho, Victor Jesus Lara Ameca, Denise Monserrat Rendón Olguín

引用次数: 0

Letter to the Editor: Use of Catheterization Algorithms to Manage Acute Urinary Retention; What is the Evidence? 致编辑的信：使用导管插入算法处理急性尿潴留；证据是什么？

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2025-02-01 DOI: 10.1016/j.urology.2024.09.034

Geehan Suleyman , Banna Hussain , Ali A. Dabaja

引用次数: 0

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