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Highlighting the 2025 AUA Nephrolithiasis Guidelines. 强调2025年AUA肾结石指南。
Pub Date : 2026-01-30 DOI: 10.1097/ju.0000000000004967
Daniel A Wollin,Michael E Lipkin,Glenn M Preminger
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引用次数: 0
Clinical trial design for BCG-unresponsive NMIBC - single-arm design was necessary, randomized trials are now essential. bcg无反应的NMIBC临床试验设计-单臂设计是必要的,随机试验现在是必要的。
Pub Date : 2026-01-30 DOI: 10.1097/ju.0000000000004960
Alon Lazarovich,David J Nusbaum,Piyush K Agarwal,Parth K Modi
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引用次数: 0
Ureteral dilation is a clinically significant risk factor for urinary tract infections in children with prenatal hydronephrosis: a call to revisit practice guidelines. 输尿管扩张是产前肾积水儿童尿路感染的临床重要危险因素:呼吁重新审视实践指南。
Pub Date : 2026-01-30 DOI: 10.1097/ju.0000000000004966
Adree Khondker,Mandy Rickard,Samer Maher,Michael Chua,Rodrigo Romao,Joana Dos Santos,Armando J Lorenzo
OBJECTIVEPediatric hydronephrosis is associated with an increased risk of urinary tract infections (UTIs). Clinical guidelines recommend continuous antibiotic prophylaxis (CAP) for high-risk patients. In this study, we evaluated the association between hydroureteronephrosis and UTIs in infants.METHODSWe performed a single-center retrospective risk analysis of patients with prenatal hydronephrosis from 2015 to 2024, including those with isolated hydronephrosis and megaureter. Demographic and imaging characteristics, including anteroposterior diameter (APD), Society for Fetal Urology (SFU) grade, and maximum ureter diameter on first postnatal ultrasound, were recorded. The primary outcome was time to UTI development. Landmark analysis and competing risk analysis with cause-specific cox regression was employed to identify hazard ratios (HRs). Model performance was determined by concordance index.RESULTSAmong 803 patients (median follow-up 23 months) included in landmark analysis, 29 developed a UTI. On initial ultrasound, 124 patients had hydroureteronephrosis and 451 patients had high-grade hydronephrosis. On cause-specific Cox regression, UTI was associated with sex, uncircumcised status, hydroureter (HR 1.15 per mm, 95% CI 1.10, 1.21, p<0.001), while hydronephrosis alone, by SFU grade or APD, was not significantly associated. Model performance showed concordance index 0.74 (optimism-adjusted 0.72).CONCLUSIONThe presence of a hydroureter on initial postnatal ultrasound is a significant risk factor for UTI in infants with prenatal hydronephrosis, which supports the value of CAP in this subgroup. In contrast, isolated hydronephrosis does not appear to justify the use of prophylaxis.
目的:儿童肾积水与尿路感染(uti)风险增加相关。临床指南推荐高危患者持续抗生素预防(CAP)。在这项研究中,我们评估了婴儿输尿管积水与尿路感染之间的关系。方法对2015年至2024年产前肾积水患者进行单中心回顾性风险分析,包括孤立性肾积水和肾积水患者。记录人口统计学和影像学特征,包括前后径(APD)、胎儿泌尿学学会(SFU)分级和产后首次超声检查的最大输尿管直径。主要结果是尿路感染发展的时间。采用里程碑分析和竞争风险分析,并结合原因特异性cox回归确定风险比(hr)。通过一致性指数来确定模型的性能。结果纳入里程碑分析的803例患者(中位随访23个月)中,29例发生尿路感染。初步超声检查,124例患者为输尿管积水,451例患者为重度肾积水。在病因特异性Cox回归中,尿路感染与性别、未割包皮状况、输尿管积水相关(风险比1.15 / mm, 95% CI 1.10, 1.21, p<0.001),而单独的肾积水(SFU分级或APD)无显著相关。模型性能的一致性指数为0.74(乐观调整后为0.72)。结论产前肾积水患儿产前超声检查中输尿管的存在是尿路感染的重要危险因素,支持CAP在该亚组中的应用价值。相反,孤立性肾积水似乎不能证明使用预防措施是合理的。
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引用次数: 0
First-in human assessment of the UroActive® electronic Artificial Urinary Sphincter for treating male stress urinary incontinence (SUI). UroActive®电子人工尿括约肌治疗男性压力性尿失禁(SUI)的首次人体评估。
Pub Date : 2026-01-21 DOI: 10.1097/ju.0000000000004945
Pierre Mozer,Aurelien Beaugerie,Marie-Aimée Perrouin-Verbe,Anne Denormandie,Juliette Cotte,Caroline Plassais,Stéphanie Tran,Dan Elliott,Emmanuel Chartier-Kastler
PURPOSETo evaluate the feasibility, safety, and efficacy during the first year of use of the UroActive® device in males with stress urinary incontinence (SUI).MATERIALS AND METHODSThis prospective, multicenter, single-arm, first-in-human study enrolled six male patients with bothersome SUI unresponsive to conservative or surgical treatments. After UroActive® implantation, follow up was planned for 5 years (post-activation). Study endpoints included successful device activation, revision, and explantation rates. Other endpoints assessed 24 h pad-weight test reduction, pad usage, uroflowmetry, post-void residual urine, patient-reported outcomes (ICIQ-UI SF, EQ-5D, I-QOL, USP). Adverse events were collected throughout the study.RESULTSAll six patients underwent successful implantation and device activation (100%). No explants or revisions were required during the 365 days post-activation. At 365 days post-activation, the pad weight was reduced by ≥50% in all patients and reduced by ≥75% in five (83.3%). Median pad use decreased from 3.7 to 1.0 pads/day. Uroflowmetry remained within acceptable ranges, and post-void residual urine was minimal. Quality of life scores significantly improved across all instruments. Nine device deficiencies were reported, all involving the patient remote control. No unanticipated serious adverse events occurred.CONCLUSIONSIn men with SUI, the UroActive® device demonstrates promising feasibility, safety, and functional outcomes during the 365 days post-activation. Patients experienced substantial symptom improvement and high satisfaction, with no surgical revisions. Larger studies with extended follow-up are needed to confirm these findings and assess long-term device performance.
目的评价男性压力性尿失禁(SUI)患者第一年使用UroActive®装置的可行性、安全性和有效性。材料和方法这项前瞻性、多中心、单臂、首次人体研究招募了6名对保守或手术治疗无反应的男性SUI患者。植入UroActive®后,计划随访5年(激活后)。研究终点包括器械成功激活、修复和外植率。其他终点评估24小时尿垫重量试验减少、尿垫使用、尿流测定、空后残余尿、患者报告结局(ICIQ-UI SF、EQ-5D、I-QOL、USP)。在整个研究过程中收集不良事件。结果6例患者均成功植入并激活器械(100%)。激活后365天内不需要外植体或修改。在激活后365天,所有患者的垫重量减少≥50%,其中5例(83.3%)减少≥75%。pad的使用中位数从每天3.7个减少到每天1.0个。尿流测量保持在可接受的范围内,空后残留尿极少。生活质量得分在所有工具中都有显著提高。报告了9个设备缺陷,均涉及患者远程控制。未发生意料之外的严重不良事件。对于SUI患者,在激活后365天内,UroActive®装置显示出良好的可行性、安全性和功能结果。患者经历了显著的症状改善和高满意度,无需手术修复。需要更大规模的长期随访研究来证实这些发现并评估设备的长期性能。
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引用次数: 0
Transitions from Regional to Widespread Pain in Urologic Chronic Pelvic Pain Syndrome (UCPPS): A MAPP II Research Network Study. 泌尿系统慢性盆腔疼痛综合征(UCPPS)从局部疼痛到广泛疼痛的转变:一项MAPP II研究网络研究。
Pub Date : 2026-01-21 DOI: 10.1097/ju.0000000000004943
J Quentin Clemens,Bruce D Naliboff,Catherine S Bradley,Claire C Yang,Daniel J Clauw,David Williams,H Henry Lai,Siobhan Sutcliffe,Steven E Harte,Theresa Spitznagle,J Richard Landis
PURPOSEWe utilized prospective data from a well-characterized urologic chronic pelvic pain (UCPPS) cohort (including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome) to identify transitions between localized pelvic pain (LP) and widespread pain (WP), and characteristics associated with these transitions.MATERIAL AND METHODSA total of 311 individuals (195 women; 116 men) with UCPPS were recruited from 6 sites and followed for 3 years. Participants completed five weekly "run-in" assessments at baseline, followed by quarterly symptom assessments. Responses on a self-reported body pain map were used to define LP vs WP (>2 non-pelvic body map regions with pain). Multivariable modeling was used to evaluate 74 baseline characteristics related to transitions between LP and WP.RESULTSAt baseline, 126 participants (41%) reported LP, 13 (10.3%) of whom transitioned to WP. Conversely, 17 of the 66 participants (26%) with WP transitioned to LP at follow-up. Progression from LP to WP was associated with: 1) not living with a partner/spouse, and 2) a higher Somatic Awareness Score on the Complex Multi-System Inventory (CMSI). Conversely, transition from WP to LP was associated with: 3) lower urinary urgency symptoms on the CMSI, and 4) higher frequency of sensation of not emptying bladder completely.CONCLUSIONSGreater levels of baseline non-painful somatic symptoms were associated with progression to widespread pain, suggesting that high baseline somatic symptoms may predict the development of future pain. Not living with a spouse/partner was also associated with progression to widespread pain, highlighting the importance of social support in UCPPS.
目的:我们利用来自一个特征明确的泌尿系统慢性盆腔疼痛(UCPPS)队列(包括间质性膀胱炎/膀胱疼痛综合征和慢性前列腺炎/慢性盆腔疼痛综合征)的前瞻性数据,来确定局限性盆腔疼痛(LP)和广泛性疼痛(WP)之间的转变,以及与这些转变相关的特征。材料与方法从6个地点共招募了311名患有UCPPS的个体(195名女性,116名男性),随访3年。参与者在基线上完成了五次每周“磨合”评估,随后进行了季度症状评估。在自我报告的身体疼痛图上的反应被用来定义LP与WP (bbbb2非骨盆身体疼痛图区域)。使用多变量建模来评估与LP和WP之间转换相关的74个基线特征。结果基线时,126名参与者(41%)报告LP,其中13名(10.3%)转变为WP。相反,66名WP参与者中有17名(26%)在随访时转变为LP。从LP到WP的进展与:1)没有与伴侣/配偶生活,以及2)在复杂多系统量表(CMSI)中较高的躯体意识得分有关。相反,从WP到LP的转变与以下因素相关:3)CMSI的尿急症状较低,4)膀胱未完全排空的感觉频率较高。结论基线非疼痛性躯体症状的高水平与广泛疼痛的进展相关,提示高基线躯体症状可能预测未来疼痛的发展。与配偶/伴侣不住在一起也与广泛疼痛的进展有关,这突出了社会支持在UCPPS中的重要性。
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引用次数: 0
Semen parameter response to varicocele repair in infertile men with cryptozoospermia. 精子参数对隐精子症不育男性精索静脉曲张修复的响应。
Pub Date : 2026-01-21 DOI: 10.1097/ju.0000000000004944
Parviz K Kavoussi,Jason Weiss,Jeissen Pyo,Romtin Mehrabani-Farsi,Laurel Foster,Arya Farahi,Negar Farzaneh,Lauren E Myers,Robert B Sloan,Parker R Brown,Shahryar K Kavoussi
PURPOSETo assess varicocele repair effect on semen parameters and improved candidacy for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) or lesser involved treatment options depending on semen parameter response following varicocele repair in infertile men presenting with baseline semen analyses revealing cryptozoospermia.MATERIALS AND METHODSA retrospective chart review of the electronic health records was performed in men presenting for fertility evaluation with a palpable varicocele on physical examination and at least 2 consecutive semen analyses revealing cryptozoospermia who underwent subinguinal microsurgical varicocele repair.RESULTSOf the 24 men with cryptozoospermia who underwent varicocele repair, 54% had improvement in semen parameters from cryptozoospermia preoperatively to semen parameters ranging from severely oligozoospermic to normozoospermic 3 to 6 months postoperatively. Statistical analyses did not demonstrate significant associations between patient age, follicle-stimulating hormone (FSH) level, or clinical grade of varicocele and semen parameter response following varicocele repair.CONCLUSIONSGreater than half of the men with cryptozoospermia that underwent varicocele repair improved semen parameters to be optimized for IVF/ICSI or potentially lesser involved fertility treatments and obviated the need for surgical sperm retrieval. Neither patient age, serum FSH level, nor clinical grade of varicocele showed a statistically significant association with favorable versus unfavorable semen parameter response to varicocele repair in infertile men with preoperative cryptozoospermia.This data suggests varicocele repair may be offered to infertile, cryptozoospermic men with palpable varicoceles.
目的评估精索静脉曲张修复对精液参数的影响,并根据基线精液分析显示隐精子症的精索静脉曲张修复后精液参数的反应,提高体外受精/卵胞浆内单精子注射(IVF/ICSI)或较少涉及的治疗方案的候选资格。材料与方法回顾性分析了在体格检查中发现精索静脉曲张进行生育能力评估的男性的电子健康记录,并对至少连续2次精液分析显示有隐精子症的男性进行了腹股沟下显微手术修复精索静脉曲张。结果在24例行精索静脉曲张修复术的隐精子症患者中,54%的患者精液参数从术前的隐精子症改善到术后3 ~ 6个月的严重少精子症到正常精子症。统计分析未显示患者年龄、促卵泡激素(FSH)水平或精索静脉曲张临床分级与精索静脉曲张修复后精液参数反应之间存在显著关联。结论:半数以上行精索静脉曲张修复术的隐精子症患者精液参数得到改善,可用于IVF/ICSI或可能较少涉及的生育治疗,无需手术取精。患者年龄、血清FSH水平和精索静脉曲张的临床分级均未显示术前伴有隐精子症的不育男性精索静脉曲张修复时精液参数反应的有利与不利相关。这一数据提示精索静脉曲张修补术可用于可触及精索静脉曲张的不育、隐精子症患者。
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引用次数: 0
Is This the End of the "Letter to the Editor"? 这是“给编辑的信”的结尾吗?
Pub Date : 2026-01-20 DOI: 10.1097/ju.0000000000004929
D Robert Siemens
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引用次数: 0
Vasectomy and the Risk of Prostate Cancer. 输精管切除术与前列腺癌的风险。
Pub Date : 2026-01-20 DOI: 10.1097/ju.0000000000004937
Peter N Schlegel,Sarah C Vij,Christopher Filson,Alfredo Penzo-Mendez,Akanksha Mehta
{"title":"Vasectomy and the Risk of Prostate Cancer.","authors":"Peter N Schlegel,Sarah C Vij,Christopher Filson,Alfredo Penzo-Mendez,Akanksha Mehta","doi":"10.1097/ju.0000000000004937","DOIUrl":"https://doi.org/10.1097/ju.0000000000004937","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"100 1","pages":"101097JU0000000000004937"},"PeriodicalIF":0.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How "Floor Bias" in Gleason Grading Affects Prostate Cancer Management. Gleason分级中的“最低偏差”如何影响前列腺癌的治疗。
Pub Date : 2026-01-16 DOI: 10.1097/ju.0000000000004921
Ian M Thompson
{"title":"How \"Floor Bias\" in Gleason Grading Affects Prostate Cancer Management.","authors":"Ian M Thompson","doi":"10.1097/ju.0000000000004921","DOIUrl":"https://doi.org/10.1097/ju.0000000000004921","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"69 1","pages":"101097JU0000000000004921"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply: Concerns Regarding the Recent Cochrane Review on Vaginal Lasers for Treating Stress Urinary Incontinence in Women. 回复:对阴道激光治疗女性压力性尿失禁的Cochrane综述的关注。
Pub Date : 2026-01-15 DOI: 10.1097/ju.0000000000004924
Giulia M Ippolito,Irene Crescenze,Phillipp Dahm,Priyanka Gupta
{"title":"Reply: Concerns Regarding the Recent Cochrane Review on Vaginal Lasers for Treating Stress Urinary Incontinence in Women.","authors":"Giulia M Ippolito,Irene Crescenze,Phillipp Dahm,Priyanka Gupta","doi":"10.1097/ju.0000000000004924","DOIUrl":"https://doi.org/10.1097/ju.0000000000004924","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"1 1","pages":"101097JU0000000000004924"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
The Journal of Urology
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