Pub Date : 2026-01-15DOI: 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}
Pub Date : 2026-01-14DOI: 10.1097/ju.0000000000004857
Hannah Warren,Maxine Tran,Phillip Pierorazio
{"title":"Renal oncocytoma: when (if ever) to operate?","authors":"Hannah Warren,Maxine Tran,Phillip Pierorazio","doi":"10.1097/ju.0000000000004857","DOIUrl":"https://doi.org/10.1097/ju.0000000000004857","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"56 1","pages":"101097JU0000000000004857"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971831","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}
Pub Date : 2026-01-13DOI: 10.1097/ju.0000000000004934
Koji Shiraishi,Satoshi Tokitaka,Yoshimasa Ban,Shintaro Oka
INTRODUCTIONVaricocele occurs in up to 20% of adolescent boys and is associated with impaired testicular growth and potential infertility. While surgical indications based on testicular asymmetry are established, the optimal age for intervention remains unclear. This study evaluated the long-term associations between varicocelectomy and testicular growth and semen parameters in children/adolescents, with special attention to pre-adolescent patients.MATERIALS AND METHODSWe retrospectively analyzed 125 patients from a registry (2011-2022) who underwent annual follow-up until age 20. Inclusion required left-sided grade II-III varicocele with persistent >20% or >2 ml testicular asymmetry. All surgeries were performed microsurgically by a single surgeon. Testicular volumes were measured ultrasonographically; catch-up growth was defined as <20% asymmetry within one year. After age 20, semen analysis was offered, and total motile sperm count (TMSC) was calculated. Associations between surgical management and outcomes were assessed.RESULTSCatch-up growth occurred in 92% of surgical patients versus 20% in conservatively managed patients (p<0.01). At age 20, left and total testicular volumes were higher in the surgical group (17.9±4.5 and 36.0±8.8 ml) than in the non-surgical group (15.8±2.0 and 32.3±4.1 ml, p<0.001). Semen analyses (n=82) indicated higher TMSC in patients who underwent surgery (5914.8×106 vs. 2124.5×106, p<0.001). Earlier surgery (elementary/junior high school) was associated higher adult testicular volume and TMSC compared with high school intervention. Eight patients (8%) showed no catch-up growth; two had Klinefelter syndrome.CONCLUSIONSIn this observational cohort, varicocelectomy was associated with improved testicular growth and higher spermatogenesis measures into adulthood. These findings highlight associations between timing of surgery and outcomes, supporting further investigation to inform optimal surgical indications.
{"title":"Long-Term Outcomes of Varicocelectomy in Children and Adolescents: Impact of Timing on Testicular Growth and Spermatogenesis.","authors":"Koji Shiraishi,Satoshi Tokitaka,Yoshimasa Ban,Shintaro Oka","doi":"10.1097/ju.0000000000004934","DOIUrl":"https://doi.org/10.1097/ju.0000000000004934","url":null,"abstract":"INTRODUCTIONVaricocele occurs in up to 20% of adolescent boys and is associated with impaired testicular growth and potential infertility. While surgical indications based on testicular asymmetry are established, the optimal age for intervention remains unclear. This study evaluated the long-term associations between varicocelectomy and testicular growth and semen parameters in children/adolescents, with special attention to pre-adolescent patients.MATERIALS AND METHODSWe retrospectively analyzed 125 patients from a registry (2011-2022) who underwent annual follow-up until age 20. Inclusion required left-sided grade II-III varicocele with persistent >20% or >2 ml testicular asymmetry. All surgeries were performed microsurgically by a single surgeon. Testicular volumes were measured ultrasonographically; catch-up growth was defined as <20% asymmetry within one year. After age 20, semen analysis was offered, and total motile sperm count (TMSC) was calculated. Associations between surgical management and outcomes were assessed.RESULTSCatch-up growth occurred in 92% of surgical patients versus 20% in conservatively managed patients (p<0.01). At age 20, left and total testicular volumes were higher in the surgical group (17.9±4.5 and 36.0±8.8 ml) than in the non-surgical group (15.8±2.0 and 32.3±4.1 ml, p<0.001). Semen analyses (n=82) indicated higher TMSC in patients who underwent surgery (5914.8×106 vs. 2124.5×106, p<0.001). Earlier surgery (elementary/junior high school) was associated higher adult testicular volume and TMSC compared with high school intervention. Eight patients (8%) showed no catch-up growth; two had Klinefelter syndrome.CONCLUSIONSIn this observational cohort, varicocelectomy was associated with improved testicular growth and higher spermatogenesis measures into adulthood. These findings highlight associations between timing of surgery and outcomes, supporting further investigation to inform optimal surgical indications.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"22 1","pages":"101097JU0000000000004934"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961546","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}
Pub Date : 2026-01-13DOI: 10.1097/ju.0000000000004936
Abraham Morgentaler,Abdulmaged M Traish
PURPOSE1) To review the evidence whether "testosterone drives prostate cancer"; 2) to dissect the arguments supporting this belief; and 3) to present the new framework of androgen adequacy versus inadequacy to explain the relationship of testosterone and prostate cancer.MATERIALS AND METHODSA MEDLINE review of the literature was performed.RESULTSThe belief that testosterone (T) drives prostate cancer (PCa) originated with Charles Huggins in 1941, led to a near-complete prohibition against T therapy (TTh) for 60 years, and persists today in regulatory warnings, guideline restrictions, and widespread clinical concerns. However, the evidence is now overwhelming that T does not drive PCa. Biopsy studies show PCa risk is unrelated to endogenous androgen concentrations. Large RCTs reveal identical PCa rates in men receiving TTh versus placebo. TTh in men with known PCa has not shown increased rates of recurrence or progression. While androgens are required for PCa growth, PCa growth also requires other chemicals, e.g., calcium. What is unique to androgens is it is the only required chemical that does not cause loss of life with severe deprivation. The key concept to understand the relationship of androgens and PCa is adequacy versus inadequacy. Adequate T concentrations for optimal PCa growth occur at a low concentration called the saturation point. Below this, cellular metabolism is compromised and cell death may occur depending on degree of deprivation.CONCLUSIONSTestosterone does not drive prostate cancer. Androgen adequacy versus inadequacy provides a scientifically sound framework to understand the relationship of testosterone and prostate pathophysiology.
{"title":"TESTOSTERONE DOES NOT DRIVE PROSTATE CANCER: PRESENTING THE NEW FRAMEWORK OF ANDROGEN ADEQUACY VERSUS INADEQUACY.","authors":"Abraham Morgentaler,Abdulmaged M Traish","doi":"10.1097/ju.0000000000004936","DOIUrl":"https://doi.org/10.1097/ju.0000000000004936","url":null,"abstract":"PURPOSE1) To review the evidence whether \"testosterone drives prostate cancer\"; 2) to dissect the arguments supporting this belief; and 3) to present the new framework of androgen adequacy versus inadequacy to explain the relationship of testosterone and prostate cancer.MATERIALS AND METHODSA MEDLINE review of the literature was performed.RESULTSThe belief that testosterone (T) drives prostate cancer (PCa) originated with Charles Huggins in 1941, led to a near-complete prohibition against T therapy (TTh) for 60 years, and persists today in regulatory warnings, guideline restrictions, and widespread clinical concerns. However, the evidence is now overwhelming that T does not drive PCa. Biopsy studies show PCa risk is unrelated to endogenous androgen concentrations. Large RCTs reveal identical PCa rates in men receiving TTh versus placebo. TTh in men with known PCa has not shown increased rates of recurrence or progression. While androgens are required for PCa growth, PCa growth also requires other chemicals, e.g., calcium. What is unique to androgens is it is the only required chemical that does not cause loss of life with severe deprivation. The key concept to understand the relationship of androgens and PCa is adequacy versus inadequacy. Adequate T concentrations for optimal PCa growth occur at a low concentration called the saturation point. Below this, cellular metabolism is compromised and cell death may occur depending on degree of deprivation.CONCLUSIONSTestosterone does not drive prostate cancer. Androgen adequacy versus inadequacy provides a scientifically sound framework to understand the relationship of testosterone and prostate pathophysiology.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"267 1","pages":"101097JU0000000000004936"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961545","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}
Pub Date : 2026-01-13DOI: 10.1097/ju.0000000000004935
Kevin J Hebert,Seth Swinney,Ryan Johnson,Joemy Ramsay,Kiarad Fendereski,Molly DeWitt-Foy,Sean Elliott,Elizabeth Bearrick,Patricia Maymi-Castrodad,John T Stoffel,Amanda Seyer,Boyd R Viers,Benjamin J McCormick,Jeremy B Myers
PURPOSETo assess outcomes following colon conduit urinary diversion (CCUD) with and without concurrent colon anastomosis.MATERIALS AND METHODSPatients who underwent CCUD were retrospectively identified at four institutions. Primary outcomes included: 0-90 day high-grade complications, 30-day readmission, and late interventions. Secondary outcomes included high-grade complications and their association with concurrent colonic anastomosis, prior radiation, and hypoalbuminemia. The cohort was sub-stratified into 1) CCUD with colonic anastomosis, 2) CCUD with colostomy, and 3) colostomy switch. Patient characteristics, perioperative variables, and outcomes were compared between groups using descriptive, univariable, and multivariable statistics.RESULTS179 patients, median age 61 years, underwent CCUD between 1990 and 2022. Prior radiation therapy (63.7%), genitourinary surgery (54%), and abdominal surgery (72%) was common within the cohort. Outcomes included: 30-day high-grade complications (28.5%), 30-90 day high-grade complications (14.5%), and 90-day mortality (4.5%). 90-day reintervention (surgical or procedural) was 30.2%. The most common late complication was need for ureteral stent or nephrostomy tube (16.8%). Preoperative albumin ≥3.2 was associated with reduced 30-90 day high-grade complications (HR 0.18). Development of high-grade complication during postoperative day 0-30 was associated with an increased likelihood of developing a secondary high-grade complication between postoperative day 30-90 (HR 2.85).CONCLUSIONSThe presence of a colonic anastomosis at the time of colon conduit urinary was not associated with worse 30-day outcomes. Hypoalbuminemia was associated with an increased likelihood of 30-90 day high-grade complications. Use of colon remains an important option for urinary diversion surgery when ileum is not clinically feasible.
{"title":"Outcomes Following Colon Conduit Urinary Diversion: A Multi-institutional Retrospective Study from the RADIO (Reconstruction And Diversion: Improving Outcomes) Group.","authors":"Kevin J Hebert,Seth Swinney,Ryan Johnson,Joemy Ramsay,Kiarad Fendereski,Molly DeWitt-Foy,Sean Elliott,Elizabeth Bearrick,Patricia Maymi-Castrodad,John T Stoffel,Amanda Seyer,Boyd R Viers,Benjamin J McCormick,Jeremy B Myers","doi":"10.1097/ju.0000000000004935","DOIUrl":"https://doi.org/10.1097/ju.0000000000004935","url":null,"abstract":"PURPOSETo assess outcomes following colon conduit urinary diversion (CCUD) with and without concurrent colon anastomosis.MATERIALS AND METHODSPatients who underwent CCUD were retrospectively identified at four institutions. Primary outcomes included: 0-90 day high-grade complications, 30-day readmission, and late interventions. Secondary outcomes included high-grade complications and their association with concurrent colonic anastomosis, prior radiation, and hypoalbuminemia. The cohort was sub-stratified into 1) CCUD with colonic anastomosis, 2) CCUD with colostomy, and 3) colostomy switch. Patient characteristics, perioperative variables, and outcomes were compared between groups using descriptive, univariable, and multivariable statistics.RESULTS179 patients, median age 61 years, underwent CCUD between 1990 and 2022. Prior radiation therapy (63.7%), genitourinary surgery (54%), and abdominal surgery (72%) was common within the cohort. Outcomes included: 30-day high-grade complications (28.5%), 30-90 day high-grade complications (14.5%), and 90-day mortality (4.5%). 90-day reintervention (surgical or procedural) was 30.2%. The most common late complication was need for ureteral stent or nephrostomy tube (16.8%). Preoperative albumin ≥3.2 was associated with reduced 30-90 day high-grade complications (HR 0.18). Development of high-grade complication during postoperative day 0-30 was associated with an increased likelihood of developing a secondary high-grade complication between postoperative day 30-90 (HR 2.85).CONCLUSIONSThe presence of a colonic anastomosis at the time of colon conduit urinary was not associated with worse 30-day outcomes. Hypoalbuminemia was associated with an increased likelihood of 30-90 day high-grade complications. Use of colon remains an important option for urinary diversion surgery when ileum is not clinically feasible.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"43 1","pages":"101097JU0000000000004935"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961547","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}
Pub Date : 2026-01-13DOI: 10.1097/ju.0000000000004933
Naeem Bhojani,Sri Sivalingam,Kymora B Scotland,Michael Ordon,Shubha De,Céline Gélinas,Abbas Guennoun,Kahina Bensaadi,Louisa Ho,Andrea G Lantz,Vernon M Pais,Jason Y Lee,Sero Andonian,Ben H Chew
PURPOSEWe sought to develop and validate the Canadian Endourology Group Stent Symptom Score (CEGSSS), a short and concise ureteral stent symptom questionnaire to assess the patient-reported impact of ureteral stents in patients with indwelling stents for <2weeks.MATERIALS AND METHODSWe utilized a rigorous 3-phase study design: Phase 1 (P1): Prioritizing domains/items to be included in a minimal needs data set with the help of patient partners and experts. Phase 2 (P2): Pilot study of patients with ureteral stents evaluating the feasibility and acceptability of the CEGSSS. Phase 3 (P3): Multicentric, North American prospective study evaluating the validity and reliability of the CEGSSS.RESULTSP1: The first version of the CEGSSS was developed which included 15 items and 3 domains (urinary symptoms, pain, and quality of life). P2: 3 cycles were required to reach data saturation. Patient, and expert feedback was incorporated into the final version of the CEGSSS. The final version of the CEGSSS included 11 items and 3 domains. P3: 287 patients were enrolled. Exploratory factor analysis determined that 3 domains was appropriate. All domains and the overall questionnaire showed acceptable to very good internal consistency (Cronbach's α between 0.60 and 0.81). Test-retest on day 1 and 3 indicated good reliability (intraclass correlation between 0.71 and 0.79) and responsiveness to change and sensitivity to change showed statistically significant differences in total scores for all domains (Wilcoxon signed rank test, p<0.001).CONCLUSIONSThis 3-phase development, reliability and validation study confirms the utility of a new ureteral stent symptoms questionnaire. The CEGSSS is a practical, user-friendly tool that is quicker to complete than the USSQ.
{"title":"Development and Initial Validation of a New Stent Symptom Questionnaire for short term dwell time: The Canadian Endourology Group Stent Symptom Score (CEGSSS).","authors":"Naeem Bhojani,Sri Sivalingam,Kymora B Scotland,Michael Ordon,Shubha De,Céline Gélinas,Abbas Guennoun,Kahina Bensaadi,Louisa Ho,Andrea G Lantz,Vernon M Pais,Jason Y Lee,Sero Andonian,Ben H Chew","doi":"10.1097/ju.0000000000004933","DOIUrl":"https://doi.org/10.1097/ju.0000000000004933","url":null,"abstract":"PURPOSEWe sought to develop and validate the Canadian Endourology Group Stent Symptom Score (CEGSSS), a short and concise ureteral stent symptom questionnaire to assess the patient-reported impact of ureteral stents in patients with indwelling stents for <2weeks.MATERIALS AND METHODSWe utilized a rigorous 3-phase study design: Phase 1 (P1): Prioritizing domains/items to be included in a minimal needs data set with the help of patient partners and experts. Phase 2 (P2): Pilot study of patients with ureteral stents evaluating the feasibility and acceptability of the CEGSSS. Phase 3 (P3): Multicentric, North American prospective study evaluating the validity and reliability of the CEGSSS.RESULTSP1: The first version of the CEGSSS was developed which included 15 items and 3 domains (urinary symptoms, pain, and quality of life). P2: 3 cycles were required to reach data saturation. Patient, and expert feedback was incorporated into the final version of the CEGSSS. The final version of the CEGSSS included 11 items and 3 domains. P3: 287 patients were enrolled. Exploratory factor analysis determined that 3 domains was appropriate. All domains and the overall questionnaire showed acceptable to very good internal consistency (Cronbach's α between 0.60 and 0.81). Test-retest on day 1 and 3 indicated good reliability (intraclass correlation between 0.71 and 0.79) and responsiveness to change and sensitivity to change showed statistically significant differences in total scores for all domains (Wilcoxon signed rank test, p<0.001).CONCLUSIONSThis 3-phase development, reliability and validation study confirms the utility of a new ureteral stent symptoms questionnaire. The CEGSSS is a practical, user-friendly tool that is quicker to complete than the USSQ.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"187 1","pages":"101097JU0000000000004933"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961544","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}
Pub Date : 2026-01-13DOI: 10.1097/ju.0000000000004925
Samah Daou,Chady Waked,Fouad Aoun
{"title":"Letter: Metformin Alongside ADT: Absence of Proof Is Not Proof of Absence.","authors":"Samah Daou,Chady Waked,Fouad Aoun","doi":"10.1097/ju.0000000000004925","DOIUrl":"https://doi.org/10.1097/ju.0000000000004925","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"94 1","pages":"101097JU0000000000004925"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961549","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}
Pub Date : 2026-01-13DOI: 10.1097/ju.0000000000004920
Feifei Zhang,Jingcheng Zhou,Chao Yang,Shaoqing Wei,Jiahui Ma
PURPOSETo investigate the associations between long-term exposure to PM2.5 chemical constituents and incident prostate cancer, considering potential effect modification by genetic susceptibility and lifestyle.MATERIALS AND METHODSWe conducted a prospective study of 224,272 male participants from the UK Biobank with a median follow-up of 13.7 years. Individual exposures to PM2.5 and its 5 key constituents (SO42-, NO3-, NH4+, elemental carbon [EC], and organic matter [OM]) were modeled. Prostate cancer incidence was ascertained through national cancer registries. We used Cox proportional hazard models to estimate associations, quantile g-computation for joint effects, and interaction analyses to evaluate effect modification by lifestyle and polygenic risk scores (PRS).RESULTSHigh exposures to PM2.5, SO42-, NO3-, and NH4+ were significantly associated with increased prostate cancer risk, and NO3- showed the strongest association (HR per interquartile range: 1.088). The pollutant mixture had a positive joint effect, with NO3- contributing approximately 76.6% of this effect. Genetic predisposition, assessed by PRS, was a strong independent predictor of prostate cancer (HR for high vs low PRS: 6.527). No interaction effects were identified for the associations of lifestyle and PRS with PM2.5 constituents.CONCLUSIONSSpecific PM2.5 constituents, particularly NO3- and NH4+, are associated with an elevated prostate cancer risk, independent of genetic and lifestyle factors. These findings suggest that public health interventions targeting air pollution sources and modifiable behaviors may help reduce disease burden.
{"title":"Air Pollution, Lifestyle, and Genetic Risk: A Multidimensional Study of PM2.5 Constituents and Prostate Cancer.","authors":"Feifei Zhang,Jingcheng Zhou,Chao Yang,Shaoqing Wei,Jiahui Ma","doi":"10.1097/ju.0000000000004920","DOIUrl":"https://doi.org/10.1097/ju.0000000000004920","url":null,"abstract":"PURPOSETo investigate the associations between long-term exposure to PM2.5 chemical constituents and incident prostate cancer, considering potential effect modification by genetic susceptibility and lifestyle.MATERIALS AND METHODSWe conducted a prospective study of 224,272 male participants from the UK Biobank with a median follow-up of 13.7 years. Individual exposures to PM2.5 and its 5 key constituents (SO42-, NO3-, NH4+, elemental carbon [EC], and organic matter [OM]) were modeled. Prostate cancer incidence was ascertained through national cancer registries. We used Cox proportional hazard models to estimate associations, quantile g-computation for joint effects, and interaction analyses to evaluate effect modification by lifestyle and polygenic risk scores (PRS).RESULTSHigh exposures to PM2.5, SO42-, NO3-, and NH4+ were significantly associated with increased prostate cancer risk, and NO3- showed the strongest association (HR per interquartile range: 1.088). The pollutant mixture had a positive joint effect, with NO3- contributing approximately 76.6% of this effect. Genetic predisposition, assessed by PRS, was a strong independent predictor of prostate cancer (HR for high vs low PRS: 6.527). No interaction effects were identified for the associations of lifestyle and PRS with PM2.5 constituents.CONCLUSIONSSpecific PM2.5 constituents, particularly NO3- and NH4+, are associated with an elevated prostate cancer risk, independent of genetic and lifestyle factors. These findings suggest that public health interventions targeting air pollution sources and modifiable behaviors may help reduce disease burden.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"141 1","pages":"101097JU0000000000004920"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961548","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}
Pub Date : 2025-12-29DOI: 10.1097/ju.0000000000004891
Runhua Tang,Liuqi Song,Jianlong Wang,Pengjie Wu
{"title":"A Simple Method to Improve Surgical Field Clarity in Endourology: The Application of Povidone-Iodine Irrigation.","authors":"Runhua Tang,Liuqi Song,Jianlong Wang,Pengjie Wu","doi":"10.1097/ju.0000000000004891","DOIUrl":"https://doi.org/10.1097/ju.0000000000004891","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"42 1","pages":"101097JU0000000000004891"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847525","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}
Pub Date : 2025-12-23DOI: 10.1097/ju.0000000000004911
Steven P Rowe,Salikh Murtazaliev,Alireza Amindarolzarbi,Sara Sheikhbahaei,Alexa R Meyer,Mehrbod S Javadi,McKenna Wood,Basil Kauffman,Reema Goel,Benjamin L Viglianti,Christian P Pavlovich,Nirmish Singla,Philip M Pierorazio,Alex S Baras,Jonathan I Epstein,Ezra Baraban,Mohamad E Allaf,Lilja B Solnes,Jorge D Oldan,Hiten D Patel,Michael A Gorin
BACKGROUND AND OBJECTIVEAnatomic imaging and biopsy have limitations in the risk stratification of indeterminate renal masses. Molecular imaging offers opportunities to improve non-invasive risk stratification. 99mTc-sestamibi is a mitochondrial imaging agent that has shown increased uptake in benign/indolent renal tumors and a lack of uptake in aggressive renal cell carcinomas (RCCs).METHODSWe evaluated the accuracy of 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) imaging to characterize histologically diagnosed renal masses using two cohorts of patients; one from a prospective scan-and-resect clinical trial and a second from routine clinical care. The rate of renal mass positivity (i.e. "hot tumors") on 99mTc-sestamibi SPECT/CT was stratified by histology. Diagnostic performance to identify histologic groupings of interest was measured by sensitivity and specificity.KEY FINDINGS AND LIMITATIONS344 patients with 361 tumors (124 trial, 237 clinical) were included. Most clear cell RCC (97%) and papillary or clear cell papillary RCC (80-84%) were cold while chromophobe RCCs were equally likely to be hot or cold (52% vs. 48%). Surgically resected oncocytomas tended to be hot (69%), with even higher positivity for biopsy with oncocytic neoplasms in the clinical cohort (87%). Limitations included the heterogeneous nature of the cohort and the use of biopsy for histologic diagnosis in the clinical cohort.CONCLUSIONS AND CLINICAL IMPLICATIONS99mTc-sestamibi SPECT/CT is a novel method to effectively risk-stratify indeterminate renal masses. As with any non-surgical method for renal mass characterization, there are potential false positives and false negatives, and those should be weighed carefully in shared decision-making with the patient to guide further evaluation and management.
{"title":"Performance of 99mTc-sestamibi SPECT/CT for Characterizing Renal Masses: Combined Results from a Prospective Scan-and-Resect Trial and Clinical Experience.","authors":"Steven P Rowe,Salikh Murtazaliev,Alireza Amindarolzarbi,Sara Sheikhbahaei,Alexa R Meyer,Mehrbod S Javadi,McKenna Wood,Basil Kauffman,Reema Goel,Benjamin L Viglianti,Christian P Pavlovich,Nirmish Singla,Philip M Pierorazio,Alex S Baras,Jonathan I Epstein,Ezra Baraban,Mohamad E Allaf,Lilja B Solnes,Jorge D Oldan,Hiten D Patel,Michael A Gorin","doi":"10.1097/ju.0000000000004911","DOIUrl":"https://doi.org/10.1097/ju.0000000000004911","url":null,"abstract":"BACKGROUND AND OBJECTIVEAnatomic imaging and biopsy have limitations in the risk stratification of indeterminate renal masses. Molecular imaging offers opportunities to improve non-invasive risk stratification. 99mTc-sestamibi is a mitochondrial imaging agent that has shown increased uptake in benign/indolent renal tumors and a lack of uptake in aggressive renal cell carcinomas (RCCs).METHODSWe evaluated the accuracy of 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) imaging to characterize histologically diagnosed renal masses using two cohorts of patients; one from a prospective scan-and-resect clinical trial and a second from routine clinical care. The rate of renal mass positivity (i.e. \"hot tumors\") on 99mTc-sestamibi SPECT/CT was stratified by histology. Diagnostic performance to identify histologic groupings of interest was measured by sensitivity and specificity.KEY FINDINGS AND LIMITATIONS344 patients with 361 tumors (124 trial, 237 clinical) were included. Most clear cell RCC (97%) and papillary or clear cell papillary RCC (80-84%) were cold while chromophobe RCCs were equally likely to be hot or cold (52% vs. 48%). Surgically resected oncocytomas tended to be hot (69%), with even higher positivity for biopsy with oncocytic neoplasms in the clinical cohort (87%). Limitations included the heterogeneous nature of the cohort and the use of biopsy for histologic diagnosis in the clinical cohort.CONCLUSIONS AND CLINICAL IMPLICATIONS99mTc-sestamibi SPECT/CT is a novel method to effectively risk-stratify indeterminate renal masses. As with any non-surgical method for renal mass characterization, there are potential false positives and false negatives, and those should be weighed carefully in shared decision-making with the patient to guide further evaluation and management.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"21 1","pages":"101097JU0000000000004911"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145813506","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}
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