Pub Date : 2026-03-01Epub Date: 2025-12-27DOI: 10.1016/j.urology.2025.12.033
Yi-Hsuan Hung , Joshua Wang
{"title":"Letter to the Editor on “Cannabis Use Is Associated With Lower Urinary Tract Symptoms in Pediatric Patients—A Large Claims Database Study”","authors":"Yi-Hsuan Hung , Joshua Wang","doi":"10.1016/j.urology.2025.12.033","DOIUrl":"10.1016/j.urology.2025.12.033","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 166-167"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858074","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 : 2026-03-01Epub Date: 2026-01-14DOI: 10.1016/j.urology.2026.01.010
Makenna Romanelli , Sarah C. Vij
{"title":"Reply to Editorial Comment on “Microscopic Spermatic Cord Denervation for Chronic Scrotal Content Pain Following Inguinal Hernia Repair: Outcomes and Predictors of Success”","authors":"Makenna Romanelli , Sarah C. Vij","doi":"10.1016/j.urology.2026.01.010","DOIUrl":"10.1016/j.urology.2026.01.010","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Page 158"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990839","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 : 2026-03-01Epub Date: 2025-12-06DOI: 10.1016/j.urology.2025.11.248
Peyman Mokhtarzadehazar, Blake Ferguson, Garrett Davis, Marawan M. El Tayeb
Objective
To evaluate the safety and outcomes of holmium laser enucleation of the prostate (HoLEP) in patients with a history of prior surgical prostate intervention, and to compare these results with the patients without previous prostate intervention.
Methods
A retrospective review of a prospectively maintained database at a tertiary-level center in Texas. From August 2015 to February 2025, 1876 patients underwent HoLEP, 143 had previous prostate surgery. These were matched 1:1 with 143 patients without prior surgery based on prostate weight. Data included IPSS, hemoglobin reduction, resected tissue weight, enucleation and morcellation efficacy, prostate volume, and estimated blood loss (EBL).
Results
A total of 286 patients. Of 143 patients with prior surgery, TURP was the most common procedure (82 cases). No significant differences were found between groups in preoperative IPSS, age, resected weight, enucleation efficacy, hemoglobin reduction, or prostate volume. At 3 months postoperatively, the IPSS was significantly lower in patients with prior surgery. Morcellation efficacy was reduced, and EBL was higher in the prior surgery group. Both groups demonstrated significant improvements in IPSS overall.
Conclusion
HoLEP is a safe and effective surgical option for BPH in both primary and re-treatment settings. Prior interventions do not significantly affect enucleation efficacy, hemoglobin reduction, or IPSS outcomes; however, they are associated with reduced morcellation efficiency and increased blood loss.
{"title":"Feasibility of Holmium Laser Enucleation of the Prostate After Prior Prostate Intervention for Benign Prostatic Hyperplasia","authors":"Peyman Mokhtarzadehazar, Blake Ferguson, Garrett Davis, Marawan M. El Tayeb","doi":"10.1016/j.urology.2025.11.248","DOIUrl":"10.1016/j.urology.2025.11.248","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety and outcomes of holmium laser enucleation of the prostate (HoLEP) in patients with a history of prior surgical prostate intervention, and to compare these results with the patients without previous prostate intervention.</div></div><div><h3>Methods</h3><div>A retrospective review of a prospectively maintained database at a tertiary-level center in Texas. From August 2015 to February 2025, 1876 patients underwent HoLEP, 143 had previous prostate surgery. These were matched 1:1 with 143 patients without prior surgery based on prostate weight. Data included IPSS, hemoglobin reduction, resected tissue weight, enucleation and morcellation efficacy, prostate volume, and estimated blood loss (EBL).</div></div><div><h3>Results</h3><div>A total of 286 patients. Of 143 patients with prior surgery, TURP was the most common procedure (82 cases). No significant differences were found between groups in preoperative IPSS, age, resected weight, enucleation efficacy, hemoglobin reduction, or prostate volume. At 3 months postoperatively, the IPSS was significantly lower in patients with prior surgery. Morcellation efficacy was reduced, and EBL was higher in the prior surgery group. Both groups demonstrated significant improvements in IPSS overall.</div></div><div><h3>Conclusion</h3><div>HoLEP is a safe and effective surgical option for BPH in both primary and re-treatment settings. Prior interventions do not significantly affect enucleation efficacy, hemoglobin reduction, or IPSS outcomes; however, they are associated with reduced morcellation efficiency and increased blood loss.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 107-111"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708812","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 : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.urology.2026.01.032
Blaise W. Abramovitz , Stephen Kisty , Sarah A. Korth , Oluwasanmi Adenaiye , Paul Rusilko , Brad E. Dicianno
{"title":"Reply to Editorial Comment on “Variability in Cystatin C- and Creatinine-estimated Glomerular Filtration Rate in Adults With Spina Bifida”","authors":"Blaise W. Abramovitz , Stephen Kisty , Sarah A. Korth , Oluwasanmi Adenaiye , Paul Rusilko , Brad E. Dicianno","doi":"10.1016/j.urology.2026.01.032","DOIUrl":"10.1016/j.urology.2026.01.032","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 9-10"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097397","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 : 2026-03-01Epub Date: 2025-11-12DOI: 10.1016/j.urology.2025.11.228
Daniel Garrett Wong , Jonathan D. Harper , Naim M. Maalouf , Joel Vetter , Hussein R. Al-Khalidi , H. Henry Lai , Brett A. Johnson , Charles D. Scales , Ziya Kirkali , Alana C. Desai , for the USDRN Investigators
Objective
To compare patient-reported stent-associated symptoms (SAS) after first- and second-stage unilateral ureteroscopy with ureteral stent placement for treatment of urinary stones.
Methods
Participants enrolled in the Study to Enhance Understanding of Stent-Associated Symptoms (STENTS) underwent unilateral URS with a ureteral stent for urinary stones and completed patient-reported outcome measures to assess SAS. Differences in pain intensity were evaluated at baseline and following first- and second-stage URS procedures. A propensity score–matched cohort of participants who underwent single-stage URS was compared to participants undergoing a two-staged procedure.
Results
Of the 424 participants who underwent unilateral URS, 40 (9.4%) had an unplanned staged procedure. Most participants (75%) undergoing a staged procedure had a narrow ureter or stricture. The median time to the second procedure was 14.0 days, with the second procedure mean operative time 25 min greater than the first stage. Preoperative pain intensity was similar before both procedures, whereas postoperative pain was lower after the second procedure compared to the first. In the matched cohort, patients reported comparable pain on POD 1, but lower pain scores in the two-stage group on PODs 3 and 5. Urinary symptoms were improved on PODs 1 and 3 after the second procedure compared to the first stage.
Conclusion
Despite a longer procedure time, pain intensity appears to be lower after a second-stage procedure compared to the first. These results may be useful in counseling patients who require staged treatment.
{"title":"Stent-associated Symptoms After Two-stage Ureteroscopy: Results From STENTS","authors":"Daniel Garrett Wong , Jonathan D. Harper , Naim M. Maalouf , Joel Vetter , Hussein R. Al-Khalidi , H. Henry Lai , Brett A. Johnson , Charles D. Scales , Ziya Kirkali , Alana C. Desai , for the USDRN Investigators","doi":"10.1016/j.urology.2025.11.228","DOIUrl":"10.1016/j.urology.2025.11.228","url":null,"abstract":"<div><h3>Objective</h3><div>To compare patient-reported stent-associated symptoms (SAS) after first- and second-stage unilateral ureteroscopy with ureteral stent placement for treatment of urinary stones.</div></div><div><h3>Methods</h3><div>Participants enrolled in the Study to Enhance Understanding of Stent-Associated Symptoms (STENTS) underwent unilateral URS with a ureteral stent for urinary stones and completed patient-reported outcome measures to assess SAS. Differences in pain intensity were evaluated at baseline and following first- and second-stage URS procedures. A propensity score–matched cohort of participants who underwent single-stage URS was compared to participants undergoing a two-staged procedure.</div></div><div><h3>Results</h3><div>Of the 424 participants who underwent unilateral URS, 40 (9.4%) had an unplanned staged procedure. Most participants (75%) undergoing a staged procedure had a narrow ureter or stricture. The median time to the second procedure was 14.0 days, with the second procedure mean operative time 25 min greater than the first stage. Preoperative pain intensity was similar before both procedures, whereas postoperative pain was lower after the second procedure compared to the first. In the matched cohort, patients reported comparable pain on POD 1, but lower pain scores in the two-stage group on PODs 3 and 5. Urinary symptoms were improved on PODs 1 and 3 after the second procedure compared to the first stage.</div></div><div><h3>Conclusion</h3><div>Despite a longer procedure time, pain intensity appears to be lower after a second-stage procedure compared to the first. These results may be useful in counseling patients who require staged treatment.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 25-29"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524312","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 : 2026-03-01Epub Date: 2025-12-05DOI: 10.1016/j.urology.2025.11.245
Ragheb Massouh, Valeria Humerez, Reynaldo Gómez
Objective
To evaluate the microbiological contamination of accidentally contaminated buccal mucosa grafts and determine the effectiveness of 2% chlorhexidine (CHX) cleansing as a decontamination method, as well as to assess the impact of intraoperative irrigation with 0.1% gentamicin solution on the prevention of surgical site infection (SSI).
Methods
Prospective descriptive study conducted in consecutive patients undergoing urethral surgery with buccal mucosa grafts (BMGs). From each patient, 4 graft segments (2×6−10 mm) were obtained: baseline microbiota (F1); contamination after 3-minute floor exposure (F2); contamination after floor exposure followed by CHX cleansing (F3); and a final sample collected after graft placement and exposure to standard gentamicin irrigation (F4). Microbiological cultures were performed for all fragments.
Results
Twenty patients met the inclusion criteria (1 female, 5%). Baseline flora (F1) was identified in 13 cases (65%), exclusively oral commensals. F2 samples were positive in 15 cases (75%) but showed no pathogenic microbes. CHX cleansing (F3) achieved complete eradication in all samples. F4 showed 6 positive cases (30%), again limited to oral commensals despite gentamicin exposure. No SSI occurred during a mean 6-month follow-up.
Conclusion
BMGs dropped to the floor were not contaminated with pathogenic bacteria. CHX was highly effective for decontamination. Irrigation with gentamicin solution did not significantly reduce commensal colonization or the incidence of SSI in this series. Appropriately cleansed accidentally contaminated BMGs may be safely reused.
{"title":"Management of Accidentally Contaminated Buccal Mucosa Grafts","authors":"Ragheb Massouh, Valeria Humerez, Reynaldo Gómez","doi":"10.1016/j.urology.2025.11.245","DOIUrl":"10.1016/j.urology.2025.11.245","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the microbiological contamination of accidentally contaminated buccal mucosa grafts and determine the effectiveness of 2% chlorhexidine (CHX) cleansing as a decontamination method, as well as to assess the impact of intraoperative irrigation with 0.1% gentamicin solution on the prevention of surgical site infection (SSI).</div></div><div><h3>Methods</h3><div>Prospective descriptive study conducted in consecutive patients undergoing urethral surgery with buccal mucosa grafts (BMGs). From each patient, 4 graft segments (2×6−10 mm) were obtained: baseline microbiota (F1); contamination after 3-minute floor exposure (F2); contamination after floor exposure followed by CHX cleansing (F3); and a final sample collected after graft placement and exposure to standard gentamicin irrigation (F4). Microbiological cultures were performed for all fragments.</div></div><div><h3>Results</h3><div>Twenty patients met the inclusion criteria (1 female, 5%). Baseline flora (F1) was identified in 13 cases (65%), exclusively oral commensals. F2 samples were positive in 15 cases (75%) but showed no pathogenic microbes. CHX cleansing (F3) achieved complete eradication in all samples. F4 showed 6 positive cases (30%), again limited to oral commensals despite gentamicin exposure. No SSI occurred during a mean 6-month follow-up.</div></div><div><h3>Conclusion</h3><div>BMGs dropped to the floor were not contaminated with pathogenic bacteria. CHX was highly effective for decontamination. Irrigation with gentamicin solution did not significantly reduce commensal colonization or the incidence of SSI in this series. Appropriately cleansed accidentally contaminated BMGs may be safely reused.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 120-124"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701645","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 : 2026-03-01Epub Date: 2025-12-11DOI: 10.1016/j.urology.2025.12.007
Parth V. Shah , Edwin Jason Abel , Joshua D. Mezrich , Andrew Z. Carey , Amy K. Taylor , Adam Bregman , David Al-Adra , David Aufhauser , Kelly M. Collins , Didier Mandelbrot , Paz Lotan , Fred T. Lee Jr , James Louis Hinshaw , Glenn O. Allen , David F. Jarrard , Kyle A. Richards , Elizabeth L. Koehne , Michael C. Risk , Daniel D. Shapiro
Objective
To compare outcomes of patients with localized renal cell carcinoma (RCC) receiving immunosuppressive therapy due to prior organ transplant to a matched cohort of nontransplant patients.
Methods
Patients were identified from a solid organ transplant database with tissue diagnosis of nonmetastatic RCC after transplantation between 2000-2020. Transplant patients were matched to nontransplant patients with nonmetastatic RCC based on treatment type, age, tumor size, and grade if available. Clinical variables and survival outcomes were compared.
Results
Among 81 transplant patients with nonmetastatic RCC (surgery 65%, ablation 23%, surveillance 11%), survival outcomes were comparable to matched nontransplant cohorts. In the surgical cohort, metastasis-free survival and overall survival did not differ between transplant and nontransplant patients, and multivariable analysis confirmed transplant status was not associated with increased risk of metastasis (HR 0.94, P = .9) or mortality (HR 1.58, P = .2). In the ablation cohort, transplant patients had better local recurrence-free survival (log-rank P = .01) compared to nontransplant patients. No difference was identified in metastasis-free or overall survival with regards to transplant status (HR 4.75, P = .2; HR 0.98, P = .9). Among patients managed with active surveillance, long-term follow-up demonstrated no differences in probability of treatment, metastatic progression, or survival, and transplantation was not associated with increased risk of death from any cause (HR 0.52, P = .5).
Conclusion
Across all management strategies, no difference was identified in outcomes for patients with nonmetastatic RCC after solid organ transplantation compared to nontransplant patients, despite chronic immunosuppression. Further studies should evaluate the role of active surveillance in this population.
{"title":"Outcomes of Patients With Localized Renal Cell Carcinoma on Immunosuppression Following Solid Organ Transplantation","authors":"Parth V. Shah , Edwin Jason Abel , Joshua D. Mezrich , Andrew Z. Carey , Amy K. Taylor , Adam Bregman , David Al-Adra , David Aufhauser , Kelly M. Collins , Didier Mandelbrot , Paz Lotan , Fred T. Lee Jr , James Louis Hinshaw , Glenn O. Allen , David F. Jarrard , Kyle A. Richards , Elizabeth L. Koehne , Michael C. Risk , Daniel D. Shapiro","doi":"10.1016/j.urology.2025.12.007","DOIUrl":"10.1016/j.urology.2025.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>To compare outcomes of patients with localized renal cell carcinoma (RCC) receiving immunosuppressive therapy due to prior organ transplant to a matched cohort of nontransplant patients.</div></div><div><h3>Methods</h3><div>Patients were identified from a solid organ transplant database with tissue diagnosis of nonmetastatic RCC after transplantation between 2000-2020. Transplant patients were matched to nontransplant patients with nonmetastatic RCC based on treatment type, age, tumor size, and grade if available. Clinical variables and survival outcomes were compared.</div></div><div><h3>Results</h3><div>Among 81 transplant patients with nonmetastatic RCC (surgery 65%, ablation 23%, surveillance 11%), survival outcomes were comparable to matched nontransplant cohorts. In the surgical cohort, metastasis-free survival and overall survival did not differ between transplant and nontransplant patients, and multivariable analysis confirmed transplant status was not associated with increased risk of metastasis (HR 0.94, <em>P</em> = .9) or mortality (HR 1.58, <em>P</em> = .2). In the ablation cohort, transplant patients had better local recurrence-free survival (log-rank <em>P</em> = .01) compared to nontransplant patients. No difference was identified in metastasis-free or overall survival with regards to transplant status (HR 4.75, <em>P</em> = .2; HR 0.98, <em>P</em> = .9). Among patients managed with active surveillance, long-term follow-up demonstrated no differences in probability of treatment, metastatic progression, or survival, and transplantation was not associated with increased risk of death from any cause (HR 0.52, <em>P</em> = .5).</div></div><div><h3>Conclusion</h3><div>Across all management strategies, no difference was identified in outcomes for patients with nonmetastatic RCC after solid organ transplantation compared to nontransplant patients, despite chronic immunosuppression. Further studies should evaluate the role of active surveillance in this population.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 81-86"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752353","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 : 2026-03-01Epub Date: 2026-01-12DOI: 10.1016/j.urology.2026.01.002
Andrew C. Bennett , Charles L. Bennett
{"title":"Editorial Comment on “Global Disparities in Urological Research: A Systematic Bibliometric Analysis of Low- and Middle-income Country Representation in Urology Journals From 2013-2023”","authors":"Andrew C. Bennett , Charles L. Bennett","doi":"10.1016/j.urology.2026.01.002","DOIUrl":"10.1016/j.urology.2026.01.002","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"209 ","pages":"Pages 59-60"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985571","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}
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