Urology最新文献

{"title":"Lymph Node Sampling in Pediatric Renal Tumors: Survey of Current Practices and Impact of Education","authors":"Kyle W. Szymanski ,&nbsp;Rodrigo R. Pessoa ,&nbsp;Joon Kyung Kim ,&nbsp;Amanda F. Buchanan ,&nbsp;Sarah L. Hecht ,&nbsp;Jonathan P. Walker ,&nbsp;Nicholas G. Cost","doi":"10.1016/j.urology.2024.09.041","DOIUrl":"10.1016/j.urology.2024.09.041","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize how often and to what extent surgeons are willing to perform retroperitoneal node sampling (RPLNS) for a unilateral renal tumor, and whether they would be encouraged to change goal number of LNs after “targeted education” (TE)</div></div><div><h3>Methods</h3><div>A survey with selected demographic and LN sampling practice questions was distributed to practicing members of the Society of Pediatric Urology (SPU). After answering a 7-question questionnaire, participants were provided with an abstract on the adequacy of LN yield for staging. This served as the TE and then participants were asked to answer a final question on LN sampling goals.</div></div><div><h3>Results</h3><div>A total of 76 (19.2%) of participants, out of 395 invitations, returned complete surveys. Cross tabulation between sampling goals before and after TE showed that among surgeons sampling 1-4 nodes, 13/24 (54.16%) would be willing to change their practice and sample ≥10 nodes. A higher proportion of participants who were already systematically surveilling 5-9 LNs would be willing to change their current practice: 30/39 (77%) would now aim for ≥10 LNs. On multivariate analysis, only willingness to sample ≥5 LNs in current practice was predictive of changing to sample ≥10 LNs after TE.</div></div><div><h3>Conclusion</h3><div>Retroperitoneal LNs are currently still under sampled by pediatric urologists operating on children and adolescents with unilateral renal tumors. TE appears to encourage change in LN sampling practices.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 222-227"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475837","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}

{"title":"Castration Levels of Testosterone Results in Atrophy of Androgen-sensitive Perineal Muscles: A Potential Biomarker for Male Hypogonadism","authors":"Nityam Rathi ,&nbsp;Zoë Blake ,&nbsp;Jason Hyman ,&nbsp;Daniel R. Nemirovsky ,&nbsp;David G. Gelikman ,&nbsp;Charles Hesswani ,&nbsp;Christopher Koller ,&nbsp;Daniel Nethala ,&nbsp;Neil Mendhiratta ,&nbsp;Alexander P. Kenigsberg ,&nbsp;Jibriel Noun ,&nbsp;William Dahut ,&nbsp;Fatima Y. Karzai ,&nbsp;W. Marston Linehan ,&nbsp;Peter A. Pinto ,&nbsp;Baris Turkbey ,&nbsp;Sandeep Gurram","doi":"10.1016/j.urology.2024.10.006","DOIUrl":"10.1016/j.urology.2024.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate MRI-based measurements of androgen-sensitive perineal/pelvic muscles in men with prostate cancer before and after androgen deprivation therapy (ADT) as a novel imaging marker for end-organ effects of hypogonadism. Diagnosing hypogonadism or testosterone deficiency (TD) requires both low serum testosterone and clinical symptoms, such as erectile dysfunction and reduced libido. However, the non-specific nature of many TD symptoms makes it challenging to initiate therapy. Objective markers of TD help to better identify patients who may benefit from testosterone supplementation; however, current markers, such as low bone mineral density, lack sensitivity. Previous studies suggest that decreased bulbocavernosus-muscle (BCM) thickness may be associated with TD, although it remains unclear if this is a correlative relationship.</div></div><div><h3>Methods</h3><div>Data were prospectively collected for patients with intermediate/high-risk localized prostate cancer enrolled in a phase II trial (NCT02430480). Patients received ADT before prostatectomy and underwent prostate MRI pre-/post-ADT. BCM, ischiocavernosus-muscle (ICM), and levator-ani-muscle (LAM) measurements were made using T2W-MRI. Paired t-tests evaluated changes in BCM/ICM/LAM width, and linear regression analyses evaluated relationships between changes in testosterone and muscle width.</div></div><div><h3>Results</h3><div>Thirty-eight consecutive patients with pre-/post-ADT MRIs were analyzed. Baseline testosterone was 286.5<!--> <!-->ng/dL, and 36/38 patients had post-ADT testosterone &lt;50<!--> <!-->ng/dL. Pre-ADT and post-ADT measurements of the bilateral BCM/ICM/LAM width were 7.16<!--> <!-->mm/7.95<!--> <!-->mm/5.53<!--> <!-->mm and 5.68<!--> <!-->mm/6.71<!--> <!-->mm/4.89<!--> <!-->mm, respectively (<em>P</em> &lt;.001). Decreases in testosterone predicted reduction in combined perineal muscle (BCM<!--> <!-->+<!--> <!-->ICM) width (<em>P</em> = .032).</div></div><div><h3>Conclusion</h3><div>Androgen deprivation led to significant and relatively rapid decreases in BCM/ICM/LAM thickness. This objective biomarker of low testosterone states may help identify patients who will potentially benefit from testosterone replacement.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 313-320"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475897","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}

{"title":"The Association Between Stone Heterogenicity and the Success of Shock Wave Lithotripsy for High Density Upper Urinary Tract Stones: A Muti-Center Prospective Cohort","authors":"Hanfeng Xu ,&nbsp;Junlong Liu ,&nbsp;Zheming Li ,&nbsp;Chengshan Ge ,&nbsp;Hongqiang Guo ,&nbsp;Shiyu Song ,&nbsp;Zhenhua Li ,&nbsp;Song Bai","doi":"10.1016/j.urology.2024.10.069","DOIUrl":"10.1016/j.urology.2024.10.069","url":null,"abstract":"<div><h3>Objective</h3><div>To prospectively investigate the predictive value of radiological stone heterogenicity for the success of shock-wave lithotripsy (SWL) in patients with high-density upper urinary tract stones.</div></div><div><h3>Methods</h3><div>This multi-center prospective study was conducted from June 2020 to December 2023. The radiological stone density index measured by computed tomography (CT) included the mean, standard deviation (SD), and coefficient variation (CV) of the Hounsfield Unit value of stones. The success was defined as no evidence of clinically significant stone fragments (≥4 mm) on a plain X-ray and ultrasound of the upper urinary tract 1 month after SWL. Binary logistic regression models were used to assess the odds ratios (ORs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Finally, 533 patients with high-density upper urinary tract stones were enrolled in this study. There were 68.5% (379/533) patients experienced success after SWL treatment. After adjusted confounding variables, compared with the patients in the lowest quartile of stone density index, the odds ratios (95% CI) for the extreme quartile was 1.42 (0.71, 2.81, <em>P</em> for trend = .443), .03 (.01, .09, <em>P</em> for trend &lt;.001), and .02 (.01, .07, <em>P</em> for trend &lt;.001) for MSD, SD, and CV, respectively. Furthermore, this linear association was confirmed only for SD and CV regardless of gender, body mass index, stone size, and stone location.</div></div><div><h3>Conclusion</h3><div>This multi-center prospective study demonstrated a positive association between the stone heterogenicity and the success of SWL in patients with high-density upper urinary tract stones regardless of gender, body mass index, stone size, and stone location. However, this association was not observed in mean stone density.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 57-63"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693718","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}

{"title":"Editorial Comment on “Vessel Sparing Nontransecting Anastomotic Reconstruction of the Posterior Urethra: Single-center Experience With Long-term Follow-up”","authors":"Bridget L. Findlay,&nbsp;Boyd R. Viers","doi":"10.1016/j.urology.2024.11.038","DOIUrl":"10.1016/j.urology.2024.11.038","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 290-291"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740710","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}

{"title":"Reply to Editorial Comment on “Castration Levels of Testosterone Results in Atrophy of Androgen-sensitive Perineal Muscles: A Potential Biomarker for Male Hypogonadism”","authors":"Sandeep Gurram,&nbsp;Nityam Rathi","doi":"10.1016/j.urology.2024.11.055","DOIUrl":"10.1016/j.urology.2024.11.055","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 323-324"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795237","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}

{"title":"Letter to the Editor on “The Diagnostic Efficacy of Rapid Urine Sediment Fluorescence Staining in Urinary Tract Infections: An Exploratory Study”","authors":"Yi Xu MM ,&nbsp;Jiafei Jin MM","doi":"10.1016/j.urology.2024.12.025","DOIUrl":"10.1016/j.urology.2024.12.025","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 73-74"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898524","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}

{"title":"Aims and Scope","authors":"","doi":"10.1016/S0090-4295(25)00066-4","DOIUrl":"10.1016/S0090-4295(25)00066-4","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Page A1"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143311677","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}

{"title":"Off-the-Shelf Implant to Bridge a Urethral Defect: Multicenter 8-Year Journey From Bench to Bed","authors":"Ganesh Vythilingam ,&nbsp;Hans M. Larsson ,&nbsp;Wei Sien Yeoh ,&nbsp;Saiful Azli Mohd Zainuddin ,&nbsp;Eva-Maria Engelhardt ,&nbsp;Anand Sanmugam ,&nbsp;Yau Lun Ch’ng ,&nbsp;Yi Xian Foong ,&nbsp;Muhd Khairul Akmal Wak Harto ,&nbsp;Kalitha Pinnagoda ,&nbsp;Hui Cheng Chen ,&nbsp;Rozanaliza Radzi ,&nbsp;Mark Hiew ,&nbsp;Nurul Hayah Khairuddin ,&nbsp;Retnagowri Rajandram ,&nbsp;Selvalingam Sothilingam ,&nbsp;Thambidorai Conjeevaram Rajendrarao ,&nbsp;Tunku Kamarul Zaman Tunku Zainol Abidin ,&nbsp;Jeffrey A. Hubbell ,&nbsp;Peter Frey ,&nbsp;Teng Aik Ong","doi":"10.1016/j.urology.2024.12.016","DOIUrl":"10.1016/j.urology.2024.12.016","url":null,"abstract":"<div><h3>Objective</h3><div>To engineer an acellular mesh to reconstruct the urethra to replace the current surgical practice of using autologous tissue grafts. Cell based approaches have shown progress. However, these have been associated with high costs and logistical challenges.</div></div><div><h3>Materials and Methods</h3><div>Acellular meshes were engineered using liquid collagen. They underwent in vitro, mechanical and bench testing by surgeons. Sixty-nine male New Zealand rabbits were used to refine the design. The final prototype based on the TissueSpan patented technology was then implanted again in a 2 cm long urethral defect in 9 rabbits and in a 4 cm long defect in 6 dogs.</div></div><div><h3>Results</h3><div>The TissueSpan technology platform allows for the manufacturing of tubular and rectangular meshes in different diameters and thicknesses. The tubular mesh acted as physical conduit to gap the urethral defect with a patent urethra demonstrated after 1<!--> <!-->month in both animal models. The mesh was absorbed within 1-3<!--> <!-->months. Spontaneous urothelial coverage of the mesh and smooth muscle cell migration into the surgical area was demonstrated even in a 4 cm long urethral defect. A first in man clinical trial was subsequently initiated.</div></div><div><h3>Conclusion</h3><div>The acellular mesh may have the potential to be an off-the-shelf product for substitution urethroplasty. Its mechanical properties allow surgeons to easily create a physical conduit while its material properties favor tissue remodeling. A large-scale clinical trial is still required to further confirm the safety, performance, and patient benefit of this new medical device.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 294-299"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Multimodal Treatment of Uterine Rhabdomyosarcoma","authors":"Meghan F. Davis,&nbsp;Thomas F. Kolon,&nbsp;Christopher J. Long","doi":"10.1016/j.urology.2024.12.020","DOIUrl":"10.1016/j.urology.2024.12.020","url":null,"abstract":"<div><div>Uterine rhabdomyosarcoma is exceedingly rare. The treatment strategy has evolved from aggressive local control with upfront surgery followed by radiation to a more conservative approach with chemotherapy followed by additional treatment pending response, which is outlined in a recent consensus statement from the International Soft-Tissue Sarcoma Consortium. We present a case of a 2-year-old with intermediate risk uterine rhabdomyosarcoma. She was treated with a multimodal regimen including chemotherapy, radiation, and surgery with abdominal hysterectomy, bilateral salpingectomy, oophoropexy, partial proximal vaginectomy, and right extravesical nonrefluxing ureteral reimplant to achieve a complete resection.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 218-221"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898534","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}

{"title":"Absence of Race/Ethnicity Reporting in Clinical Trials of True Minimally Invasive Surgical Therapies for the Treatment of Benign Prostatic Hyperplasia","authors":"Anna-Lisa V. Nguyen ,&nbsp;Mahmoud Moustafa ,&nbsp;David-Dan Nguyen ,&nbsp;David Bouhadana ,&nbsp;Tuan Thanh Nguyen ,&nbsp;Bilal Chughtai ,&nbsp;Dean S. Elterman ,&nbsp;Christopher J.D. Wallis ,&nbsp;Quoc-Dien Trinh ,&nbsp;Naeem Bhojani","doi":"10.1016/j.urology.2024.09.043","DOIUrl":"10.1016/j.urology.2024.09.043","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the extent of racial reporting and enrollment in randomized controlled trials (RCTs) of minimally invasive surgical therapies (MIST) for the office-based treatment of benign prostatic hyperplasia (BPH).</div></div><div><h3>Methods</h3><div>A systematic review was conducted for RCTs assessing 6 office-based MISTs: transurethral microwave thermotherapy (TUMT), prostatic artery embolization, prostatic urethral lift, temporary implantable nitinol device, water vapor thermal therapy, and Optilume. MEDLINE, Embase, and the Cochrane CENTRAL databases were searched up to November 3, 2023. Publications were excluded if they (1) did not address one of the aforementioned office-based MISTs for the treatment of BPH; (2) were not RCTs; (3) were an abstract or conference proceeding; or (4) were not published in English. In addition to study characteristics, data about racial reporting were collected. Two independent reviewers completed screening at title, abstract, and full-text levels, with conflicts resolved by consensus with a third reviewer.</div></div><div><h3>Results</h3><div>A total of 61 publications representing 37 unique RCTs (n = 4027 unique patients) were reviewed, with publication years spanning from 1993 to 2023. TUMT was the most frequently studied MIST. Most publications (79%) were based solely in Europe or North America. Over 50% of the publications were multicenter trials. None of the included publications reported on race/ethnicity of study participants.</div></div><div><h3>Conclusion</h3><div>None of the 61 included publications of RCTs of office-based MISTs provided information on racial/ethnic composition of study participants. There is a staggering gap in the standardization of race/ethnicity reporting and enrollment within RCTs of MISTs. More granular data on race/ethnicity allow for better generalizability and equity.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 300-308"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}