The Canadian Journal Of Urology[JOURNAL]
Sun
200 papers
Evaluation and research progress on rodent models of late-onset hypogonadism: a comprehensive review.
Liu Z, Yan X, Liu G … +4 more , Zhang J, Yu X, Chang D, Dong L
Can J Urol · 2025 Oct · PMID 41220349 · Publisher ↗
Late-onset hypogonadism (LOH), characterized by the intersection of aging and androgen deficiency, impacts the health of approximately 2%-39% of middle-aged and elderly men, underscoring the need for comprehensive resear...
Late-onset hypogonadism (LOH), characterized by the intersection of aging and androgen deficiency, impacts the health of approximately 2%-39% of middle-aged and elderly men, underscoring the need for comprehensive research. Animal models, serving as analogs of human diseases, are indispensable for investigating disease mechanisms and facilitating drug development. However, the diverse array of animal models utilized for LOH research has led to a lack of standardized modeling approaches and evaluation systems, potentially impeding progress in understanding the pathogenesis and therapeutic development. In this paper, we summarize and compile the characteristics, methods, and evaluation systems of rodent models for LOH research reported in the literature, and analyze the advantages and disadvantages of each model, to facilitate the optimal choice and development of rodent models for LOH research.
Is the Barthel index a valid tool for patient selection before urological surgery? A systematic review.
Panunzio A, Orlando R, Greco F … +6 more , Mazzucato G, Rizzo FL, D'Elia SD, Porcaro AB, Antonelli A, Tafuri A
Can J Urol · 2025 Oct · PMID 41220348 · Publisher ↗
BACKGROUND: The Barthel Index (BI) measures the level of patient independence in activities of daily living. This review aims to summarize current evidence on the use of the BI in urology, highlighting its potential as a...
BACKGROUND: The Barthel Index (BI) measures the level of patient independence in activities of daily living. This review aims to summarize current evidence on the use of the BI in urology, highlighting its potential as a tool for assessing patients prior to surgery. MATERIALS AND METHODS: A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted for studies evaluating the BI in patients undergoing urologic surgery, following Systematic Review and Meta-analyses (PRISMA) guidelines. The BI was investigated both as a descriptor of baseline or postoperative health status and a prognostic indicator. A qualitative data synthesis was provided. RESULTS: Overall, nine studies were included (three retrospective, six prospective). Surgical contexts included radical cystectomy (RC) in three studies, kidney transplantation in two, trans-urethral resection/vaporization of the prostate (TURP/TUVRP) in two, with the remainder including several different urological procedures for both oncological and non-oncological diseases. Evidence suggested that the BI reliably reflects functional status pre- and post-operatively, independently predicts major postoperative complications, prolonged hospital stay, higher healthcare costs, and poorer oncologic outcomes in RC patients. Additionally, the BI was associated with postoperative delirium in patients undergoing TURP and predicted the risk of deep vein thrombosis in patients undergoing major urological surgical procedures. CONCLUSION: The BI is a valid tool for evaluating functional reserve in urologic patients. Its preoperative application can help identify patients at higher risk of adverse outcomes, thereby facilitating personalized treatment planning and optimizing surgical care.
Impact of COVID-19 care reorganization on the prognosis of patients with bladder urothelial carcinoma: a multicentric retrospective study.
Chaumel M, Brichart N, Bruyère F … +1 more , Bourgi A
Can J Urol · 2025 Aug · PMID 40910335 · Publisher ↗
BACKGROUND: The COVID-19 pandemic disrupted healthcare systems globally, raising concerns about delayed cancer diagnosis and treatment. In France, transurethral resection of bladder tumors (TURBT) was prioritized in nati...
BACKGROUND: The COVID-19 pandemic disrupted healthcare systems globally, raising concerns about delayed cancer diagnosis and treatment. In France, transurethral resection of bladder tumors (TURBT) was prioritized in national urology guidelines to ensure the timely management of urothelial carcinoma. This study aimed to assess the impact of care reorganization on tumor staging, recurrence, palliative care, and mortality in bladder cancer patients from the pre-pandemic through late-pandemic periods. METHODS: We conducted a retrospective multicenter study including all patients who underwent TURBT with histologically confirmed urothelial carcinoma between April and December of 2019 (pre-pandemic), 2020 (early pandemic), 2021 (mid-pandemic), and 2022 (late pandemic) in two French institutions. TURBT indications were categorized as diagnostic, palliative, or staging. Clinical and pathological data were compared across the four periods. Statistical analyses included Chi-square tests, Estimated Annual Percentage Change (EAPC), and multivariable logistic regression adjusted for age, sex, ASA score, and center. RESULTS: A total of 790 TURBT procedures were analyzed. The proportion of muscle-invasive bladder cancer (pT ≥ 2) declined over time (18.7% in 2019 to 13.2% in 2022; p = 0.63), while superficial tumors (pTa) increased (57.2% to 65.5%). All-cause mortality significantly decreased from 38.0% in 2019 to 22.0% in 2020, 20.5% in 2021, and 19.5% in 2022 (p = 0.006). EAPC showed a significant annual decline in mortality (-24.3%, p = 0.004). In multivariable analysis, 2020, 2021, and 2022 were each associated with significantly lower odds of mortality compared to 2019. Recurrence rates remained stable across all periods (p = 0.93). Inter-hospital variation persisted in mortality and recurrence. CONCLUSIONS: Despite the pandemic, urothelial bladder cancer outcomes did not worsen through 2022. On the contrary, timely reorganization, prioritization of TURBT, and triage strategies were associated with reduced mortality and palliative care needs, highlighting the resilience of cancer care when guided by adaptive health policies.
"A hard pill to swallow": a case series of chlorpromazine-induced priapism.
Kwon M, Lockhart K, Reid H … +1 more , Raman A
Can J Urol · 2025 Aug · PMID 40910334 · Publisher ↗
Priapism is a rare but potentially serious adverse effect of several medications including chlorpromazine, which is commonly used in the treatment of refractory migraine. We describe three cases of ischaemic priapism occ...
Priapism is a rare but potentially serious adverse effect of several medications including chlorpromazine, which is commonly used in the treatment of refractory migraine. We describe three cases of ischaemic priapism occurring in men following intravenous chlorpromazine administration for migraine relief. These cases highlight an important but under-recognised complication that can result in long-term erectile dysfunction if not promptly managed. Clinicians should maintain a high index of suspicion for this adverse effect and ensure patients are appropriately counselled regarding the need for urgent medical review should symptoms arise.
Tumor-to-tumor metastasis: case report of a neuroendocrine tumor of the lung metastasizing to a benign oncocytoma of the kidney.
Marthi S, Mukarram M, Ardeshir-Larijani F … +2 more , Harik LR, Joshi SS
Can J Urol · 2025 Aug · PMID 40910333 · Publisher ↗
Tumor-to-tumor metastasis (TTM) is a rare phenomenon in which a secondary tumor colonizes within a primary tumor of a different histogenesis. It is hypothesized that TTM is encouraged by conditions that promote increased...
Tumor-to-tumor metastasis (TTM) is a rare phenomenon in which a secondary tumor colonizes within a primary tumor of a different histogenesis. It is hypothesized that TTM is encouraged by conditions that promote increased cell growth and division in the primary tumor, such as hypervascularity and expression of oncogenic cytokines. However, the exact causes of TTM likely vary on a case-by-case basis and are dependent on the microenvironment of both the primary and secondary tumors. Herein, we present the first reported example of TTM in which a pulmonary neuroendocrine tumor (NET) metastasizes to a renal oncocytoma.
Ventral midline approach to penile fracture with bilateral corporal injuries and complete urethral avulsion: a case report.
Driscoll CB, Handa N, Greenberg DR … +1 more , Lee Z
Can J Urol · 2025 Aug · PMID 40910332 · Publisher ↗
Penile fracture is a rare clinical entity that occurs secondary to direct trauma to an erect penis, most commonly during sexual intercourse. Specifically, increased pressure within the corpus cavernosa results in rupture...
Penile fracture is a rare clinical entity that occurs secondary to direct trauma to an erect penis, most commonly during sexual intercourse. Specifically, increased pressure within the corpus cavernosa results in rupture of the tunica albuginea. Occasionally, these injuries extend to the urethra and very rarely cause a complete urethral avulsion. Emergent exploration improves post-traumatic erectile function, penile curvature, and prevents painful erections. The traditional approach is a subcoronal circumcising incision to allow for adequate visualization. We present an uncircumcised male with bilateral corporal injuries and complete urethral avulsion who underwent a ventral midline approach for successful foreskin preservation.
Associations between ureteral stent indwelling time, patient characteristics, and stent pain from an international prospective registry.
Forbes CM, Chew BH, Wong KFV … +15 more , Ren R, Ji Y, Glaser AP, Taguchi K, Krambeck AE, Rivera ME, Shah O, Tariel E, Amarasekera C, Hamamoto S, Lange D, Molina WR, Knoedler JJ, Humphreys MR, Stern KL
Can J Urol · 2025 Aug · PMID 40910331 · Publisher ↗
OBJECTIVES: Previous studies have shown conflicting results concerning the optimal duration of ureteral stenting after endourologic treatment of stone disease, its effect on patient comfort, and the necessity for emergen...
OBJECTIVES: Previous studies have shown conflicting results concerning the optimal duration of ureteral stenting after endourologic treatment of stone disease, its effect on patient comfort, and the necessity for emergent, unscheduled care. This study assessed the impact of stent duration, sex, and other patient-associated factors on reported pain scores using a large, international prospective registry. METHODS: A prospective observational patient registry on ureteral stents from 10 institutions in 4 countries (United States, Canada, France, and Japan) from 2020-2023 was assessed. The primary outcome was Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity scores administered on the day of stent removal, before stent removal. Patients were grouped by indwelling time (short, medium, and long), and pain scores were compared. The impact of sex, height vs. stent length, and presence or absence of tether were assessed. RESULTS: 359 patients were enrolled in the database, with outcomes analyzed for 268 patients with a unilateral stent placed after an endourologic procedure for stones. No significant difference was detected in pain scores between the indwelling time groups (p = 0.41). Height for a given stent length was not significantly associated with pain scores. There was no difference in pain scores with or without tether. Men reported lower pain scores than women (p = 0.018). CONCLUSIONS: This study did not detect an overall difference in pain scores reported at stent removal within or between stent duration groups. Men reported less pain than women in this study, suggesting that patient factors may be more important than indwelling time when optimizing pain management.
How I do it: percutaneous cystolitholapaxy for bladder stones with complex lower urinary tract anatomy.
Lee MS, Sledge TR, Seyer AK … +2 more , Qi R, Koo K
Can J Urol · 2025 Aug · PMID 40910330 · Publisher ↗
While cystolitholapaxy for bladder stones is commonly performed using a transurethral approach, large or complex stone burdens in patients with complex lower urinary tract anatomy may make this inefficient or infeasible....
While cystolitholapaxy for bladder stones is commonly performed using a transurethral approach, large or complex stone burdens in patients with complex lower urinary tract anatomy may make this inefficient or infeasible. Percutaneous cystolitholapaxy is a safe, effective, minimally invasive alternative for diverse indications, including patients with benign prostatic hyperplasia, urethral stricture disease, closed bladder neck, continent catheterized channel, or other urinary diversion. In this article, we review the indications for and advantages of percutaneous cystolitholapaxy and describe our step-by-step technique for this procedure, including representative imaging and favored equipment. We also discuss preoperative and postoperative considerations, management of potential complications, strategies to optimize clinical outcomes and patient safety, and comparisons with transurethral approaches. Finally, we report outcomes from our institutional series of percutaneous cystolitholapaxy cases to highlight the safety and efficacy of the procedure.
Redo testicular sperm aspiration (TESA) in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA).
Alahmari A, Akram R, Maalouf M … +2 more , Elsayed A, Zini A
Can J Urol · 2025 Aug · PMID 40910329 · Publisher ↗
BACKGROUND: Testicular sperm aspiration (TESA) is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility. We sought to evaluate sperm retrieval outcom...
BACKGROUND: Testicular sperm aspiration (TESA) is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility. We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA). METHODS: This is a retrospective analysis of consecutive TESAs (primary and redo) for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center. We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit. RESULTS: 439 TESAs (366 primary and 73 redo) in men with severe OAT (n = 133) and OA (n = 306) were included. Men with OA had significantly higher sperm retrieval rate (SRR) and motile SRR compared to men with severe OAT (99% vs. 95% and 98% vs. 83%, respectively, p < 0.05). The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT (15% vs. 32% and 1.2 ± 0.5 vs. 1.4 ± 0.7, respectively, p < 0.05). In both groups, SRR, motile SRR, the requirement for multiple biopsies, and the total number of aspirates were not significantly different in primary compared to redo cases. CONCLUSION: Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT. The data also demonstrate that a redo TESA in these men is as effective as a primary TESA, suggesting that areas of active spermatogenesis are preserved 6 months after TESA.
Simple prostatectomy followed by radiation therapy for prostate cancer: a novel treatment pathway for men with marked prostatomegaly and prostate cancer: a series of cases.
Morgan T, Calio B, Caraccia RT … +5 more , Segal D, Kim J, Attia S, Desai NB, Gahan J
Can J Urol · 2025 Aug · PMID 40910328 · Publisher ↗
BACKGROUND: Radical prostatectomy has long been the treatment of choice for men with clinically significant prostate cancer (PCa) in those with concurrent significant lower urinary tract symptoms (LUTS). For men who meet...
BACKGROUND: Radical prostatectomy has long been the treatment of choice for men with clinically significant prostate cancer (PCa) in those with concurrent significant lower urinary tract symptoms (LUTS). For men who meet this description with marked prostatomegaly, we present a multi-institutional proof of concept study describing an alternative pathway of robotic simple prostatectomy (RASP) followed by external beam radiation therapy (EBRT) for the treatment of clinically significant prostate cancer. METHODS: A retrospective study was performed of 17 patients with PCa who underwent RASP followed by EBRT at two institutions from 2015-2023. Demographic, peri-operative, and post-radiation treatment functional outcomes are reported. RESULTS: No postoperative or post-EBRT complications were reported for any of the 17 patients who underwent RASP followed by EBRT during a median follow-up time of 12 months. The median time from RASP to EBRT was 9 months. Median prostate size was 135 g (IQR 110-165). 13 (76.5%) patients received a pre-EBRT rectal spacer. Median IPSS score preoperatively improved at 90 days post-RASP (13.5 vs. 2.5; IQR 10.8-15.2), and this benefit was sustained post-EBRT with a median IPSS at 3 vs. 12 months (4 vs. 0; IQR 0-5). There was no statistically significant difference between postoperative IPSS and post-EBRT IPSS at 3 (p = 0.677) or 12 (p = 0.627) months. In all 14 patients with localized disease and PSA data, none had recurrence during the study period. CONCLUSIONS: A subset of patients with clinically significant prostate cancer have marked prostatomegaly and LUTS. We report an alternative treatment approach for patients unwilling to undergo radical prostatectomy. We found robotic simple prostatectomy followed by definitive radiation to be feasible and safe.
Impact of metabolic syndrome on combination therapy efficacy in LUTS due to BPH: a prospective study.
Singh I, Agrawal H, Maurya V … +2 more , Gupta S, Raizada A
Can J Urol · 2025 Aug · PMID 40910327 · Publisher ↗
OBJECTIVES: Benign prostatic hyperplasia (BPH) is a common benign tumor in men, with an age-related prevalence of multifactorial etiology. The present study aimed to accurately assess and predict the effect of co-existin...
OBJECTIVES: Benign prostatic hyperplasia (BPH) is a common benign tumor in men, with an age-related prevalence of multifactorial etiology. The present study aimed to accurately assess and predict the effect of co-existing metabolic syndrome (MtS) upon treatment outcomes of combination medical therapy in select patients of lower urinary tract symptoms (LUTS) due to BPH. METHODS: After obtaining informed consent from the patients, 70 eligible patients with LUTS due to BPH with and without MtS were enrolled in this study from September 2022 to January 2024 from the outpatient clinic at the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi and were treated with a combination of Tamsulosin and Dutasteride, for two months, as per the protocol. The outcomes measured were a change in the International Prostate Symptom Score (IPSS), mean flow rate (MFR), and peak urine flow (Qmax) rates. Data was analysed using SPSS version 23. RESULTS: The reduction in IPSS was higher in the control group than in the case group (p < 0.001), and the difference in MFR between the groups was also statistically significant (p < 0.001). Although there was a significant change in Qmax in both groups, the difference in the improvement in Qmax between the two groups was not significant (p < 0.829). The control group appeared to have achieved better symptomatic relief after treatment than did the case group. CONCLUSION: Metabolic syndrome had a negative adverse impact on medical treatment outcomes in selected patients of LUTS due to BPH. The study suggests that urologists should actively consider and appropriately counsel patients with LUTS-BPH and co-existing metabolic syndrome before selecting such patients for combination medical therapy.
The cost burden of radiation cystitis presentations and investigations.
Gilmartin B, O'Meara S, Horan M … +2 more , D'Arcy FT, Dowling CM
Can J Urol · 2025 Aug · PMID 40910326 · Publisher ↗
BACKGROUND: Radiation cystitis is a well-known complication resulting from radiotherapy for pelvic malignancies. It remains a challenging condition to treat and is associated with significant morbidity for patients. We a...
BACKGROUND: Radiation cystitis is a well-known complication resulting from radiotherapy for pelvic malignancies. It remains a challenging condition to treat and is associated with significant morbidity for patients. We aimed to establish the economic cost burden of presentations and investigations associated with radiation cystitis over a two-year period to a tertiary referral hospital in Ireland. MATERIALS AND METHODS: A retrospective review of patient charts was performed for radiation cystitis-related presentations and investigations over 24 months. Costs were estimated in consultation with the hospital finance department and using Health Service Executive data on diagnostic-related groups and average inpatient bed day costs. RESULTS: A total of 56 individual patients were identified over 2 years. 91% male, 9% female. The mean age was 72 years. Twenty-three patients (41%) required inpatient care. Radiation cystitis accounted for 621 inpatient bed days. Median length of stay was 7.5 days. The inpatient care cost was approximately €545,238 (801,908 Canadian dollars (CA$)) over 2 years. CONCLUSION: Radiation cystitis accounts for a significant amount of inpatient bed days. A conservative estimate of the overall cost burden for inpatient care and outpatient investigations exceeds €280,000 (CA$411,810) per year.
Step-by-step anatomical photovaporization of the prostate using 180-W XPS greenlight laser: optimizing functional outcomes through energy modulation.
Di Maida F, Oriti F, Grosso AA … +11 more , Sessa F, Paganelli D, Salamone V, Costagli S, Solazzi F, Lambertini L, Salvi M, Dio MD, Mari A, Oriti R, Minervini A
Can J Urol · 2025 Aug · PMID 40910325 · Publisher ↗
BACKGROUND: The surgical management of patients with benign prostatic hyperplasia (BPH) has considerably evolved through recent years. Nonetheless, benefits and harms of several laser procedures are still to be determine...
BACKGROUND: The surgical management of patients with benign prostatic hyperplasia (BPH) has considerably evolved through recent years. Nonetheless, benefits and harms of several laser procedures are still to be determined. The study aimed to report perioperative and early functional results of patients treated with anatomical photo vaporization of the prostate (aPVP). METHODS: Data from consecutive patients treated with aPVP by using a 180-W XPS GreenLight laser were prospectively collected in a single tertiary center between 2020 and 2023. The surgical procedure was divided into a modular step-by-step fashion. Patients were asked to complete self-administered questionnaires at baseline and during follow-up visits. RESULTS: Overall, 176 consecutive patients were enrolled. Median age was 65 [interquartile range (IQR) 63-72] years. The baseline median prostate volume was 61.2 (IQR 52.5-71.0) mL, and the median max flow rate (Q) was 9.3 (IQR 7.8-11.5) mL/s. Median preoperative International Prostate Symptom Score (IPSS) was 25 (IQR 22-29). Overall, the median operative time was 42 (IQR 31-47) minutes with a median energy/mL of tissue delivered of 2447 kJ/mL. At 3 month-evaluation, significant improvements were observed, with a median Q of 28 (IQR: 24-32) mL/s and a median IPSS reduction of 15 (IQR: 11-18) points. A strong inverse correlation was identified between energy delivery during initial procedural steps and the severity of postoperative storage symptoms (all p < 0.05), underscoring the importance of precise energy modulation. Multivariate analysis identified increased prostate volume (odds ratio [OR]: 1.02; 95% confidence interval [CI] 1.01-1.11; p = 0.001) and higher prostate width-to-length ratio (OR: 1.28; 95% CI 1.04-1.78; p = 0.03) as independent predictors of increased energy requirements. CONCLUSIONS: aPVP with 180-W XPS GreenLight laser is a safe and effective technique showing worthy early functional results. The limitation of the energy delivered in some key phases of the procedure may be associated with a significant reduction in postoperative irritative symptoms. The shape and dimensions of the prostate also play a critical role in determining the total energy required for complete adenoma removal.
Improving surgical outcome reporting in lithiasis surgery: a comparative analysis of comprehensive complication index and clavien-dindo classification.
Katsimperis S, Tzelves L, Feretzakis G … +5 more , Bellos T, Deligiannis P, Skolarikos A, Papatsoris A, Mitsogiannis I
Can J Urol · 2025 Aug · PMID 40910324 · Publisher ↗
BACKGROUND: Accurate complication reporting in endourology remains challenging, with the Clavien-Dindo Classification and Comprehensive Complication Index being the most commonly used systems. This study aimed to compare...
BACKGROUND: Accurate complication reporting in endourology remains challenging, with the Clavien-Dindo Classification and Comprehensive Complication Index being the most commonly used systems. This study aimed to compare surgical outcomes and complication reporting in ureterolithotripsy (URL), percutaneous nephrolithotomy (PCNL), and extracorporeal shock wave lithotripsy (ESWL) using both systems. METHODS: This prospective, single-center, non-interventional study included 473 patients undergoing URL, PCNL, or ESWL from October 2022 to October 2024. Demographic, stone-related, and procedural variables were recorded. Complications were classified using the CDC, and cumulative morbidity was assessed using CCI. Statistical analyses, including univariate and multivariate regression, were performed to identify predictors of higher CCI scores. RESULTS: PCNL was associated with the highest complication rates, including an 11% transfusion rate. ESWL had the lowest complication burden, while URL demonstrated intermediate risk. CCI scores correlated positively with length of stay (LOS; r = 0.47), highlighting its ability to capture overall morbidity. Multivariate analysis identified stone size, operating time, and positive urine culture as significant predictors of higher CCI scores. The CCI provided a more comprehensive representation of morbidity compared to the CDC. CONCLUSIONS: CCI demonstrates superior sensitivity in evaluating postoperative morbidity compared to CDC, particularly in more invasive procedures such as PCNL. Standardized reporting frameworks incorporating CCI may enhance surgical outcome assessment in endourology.
Crosstalk between mitochondrial dysfunction and benign prostatic hyperplasia: unraveling the intrinsic mechanisms.
Liu H, Li Y, Qiu J … +3 more , Zhang J, Lai H, Zhang X
Can J Urol · 2025 Aug · PMID 40910323 · Publisher ↗
Benign prostatic hyperplasia (BPH) represents a prevalent etiology of lower urinary tract symptoms (LUTS) in the male population, clinically defined by a non-malignant proliferation of prostatic tissue. While BPH exhibit...
Benign prostatic hyperplasia (BPH) represents a prevalent etiology of lower urinary tract symptoms (LUTS) in the male population, clinically defined by a non-malignant proliferation of prostatic tissue. While BPH exhibits a high prevalence among older male populations globally, the precise underlying mechanisms contributing to its development remain incompletely elucidated. Mitochondria, essential organelles within eukaryotic cells, are critical for cellular bioenergetics, the regulation of reactive oxygen species (ROS) generation, and the modulation of cell death pathways. The maintenance of mitochondrial homeostasis involves a complex interplay of processes. By synthesizing previous literature, this review discusses mitochondrial homeostasis in prostate glands and the role of mitochondrial dysfunction in the context of BPH. Furthermore, the review delved into each dimension of mitochondrial dysfunction in the specific etiology of BPH, highlighting its impact on cell survival, apoptosis, ferroptosis, oxidative stress and androgen receptor (AR). Overall, this review aims to unveil the crosstalk between mitochondrial dysfunction and BPH and identify intrinsic mechanisms.
National survey of radiotherapy and androgen deprivation therapy strategies with PSMA-PET/CT integration in intermediate-risk prostate cancer: TROD 09-007 study.
Elmali A, Demirhan B, Esen CSB … +3 more , Guler OC, Hurmuz P, Onal C
Can J Urol · 2025 Aug · PMID 40910322 · Publisher ↗
BACKGROUND: Intermediate-risk prostate cancer (IR-PC) represents a heterogeneous group requiring nuanced treatment approaches, and recent advancements in radiotherapy (RT), androgen deprivation therapy (ADT), and prostat...
BACKGROUND: Intermediate-risk prostate cancer (IR-PC) represents a heterogeneous group requiring nuanced treatment approaches, and recent advancements in radiotherapy (RT), androgen deprivation therapy (ADT), and prostate-specific membrane antigen positron emission tomography (PSMA-PET/CT) imaging have prompted growing interest in personalized, risk-adapted management strategies. This study by the Turkish Society for Radiation Oncology aims to examine radiation oncologists' practices in managing IR-PC, focusing on RT and imaging modalities to identify trends for personalized treatments. METHODS: A cross-sectional survey was conducted among Turkish radiation oncologists treating at least 50 prostate cancer (PC) cases annually. The 22-item questionnaire covered IR-PC management aspects such as risk stratification, imaging preferences, androgen deprivation therapy (ADT) use and duration, RT techniques, and treatment combinations. Anonymous responses were analyzed using descriptive statistics. RESULTS: Thirty radiation oncologists participated, 57% with over 20 years of experience. The median annual number of PC cases treated was 130. For risk stratification, 43% followed the National Comprehensive Cancer Network (NCCN) guidelines, while 30% used the D'Amico classification. Imaging preferences revealed 47% favored PSMA-PET/CT. External beam RT was universally preferred, with 60% adopting ultra-hypofractionation. ADT was used by 97%, with 73% recommending it for unfavorable IR-PC cases. Short-term ADT (4-6 months) was the standard, administered concurrently with RT by 57%. Cardiovascular status influenced decisions for 97% of respondents, while 37% also considered patient age, preferences, and sexual health. CONCLUSIONS: This national survey demonstrates a shift toward personalized care in intermediate-risk prostate cancer in Turkey, marked by selective PSMA-PET/CT use, tailored ADT, and evolving radiotherapy practices. The findings underscore the importance of multidisciplinary collaboration-particularly between urologists and radiation oncologists-to optimize imaging integration and treatment outcomes.
Review of techniques and approaches for ectopic reservoir placement in inflatable penile implant.
Eigner E, Reisman Y, Fazza N … +3 more , Nsair A, Shabataev V, Zisman A
Can J Urol · 2025 Jun · PMID 40567091 · Publisher ↗
Inflatable penile prosthesis (IPP) implantation is the gold standard treatment for patients with erectile dysfunction who are refractory to medical therapy. The standard placement of the reservoir in the space of Retzius...
Inflatable penile prosthesis (IPP) implantation is the gold standard treatment for patients with erectile dysfunction who are refractory to medical therapy. The standard placement of the reservoir in the space of Retzius (SOR) may be contraindicated in patients with prior pelvic or abdominal surgery due to altered anatomy and increased risk of complications. This has led to the development of alternative ectopic reservoir placement techniques. In this narrative review, we summarize the literature on various ectopic reservoir approaches, including low and high submuscular placements, submuscular techniques with counter incisions or transfascial fixation, midline submuscular placement, subcutaneous placement, and lateral retroperitoneal approaches. We describe the surgical methods, outcomes, and complication rates associated with each technique. While most methods demonstrate low complication and revision rates, direct comparisons remain limited due to heterogeneity and lack of prospective data. This review highlights the importance of individualized technique selection based on prior surgical history, body habitus, and surgeon experience. As ectopic placement becomes more widely adopted, familiarity with multiple approaches is essential for prosthetic surgeons.
Quality of life and surgical treatment regret in patients with benign prostatic hypertrophy: a multicenter study.
Winograd J, Kindler R, Lleras C … +8 more , Codelia-Anjum A, Bhojani N, Elterman D, Diefenbach MA, Ufearo D, Kechejian K, Drangsholt S, Chughtai B
Can J Urol · 2025 Jun · PMID 40567090 · Publisher ↗
INTRODUCTION: Benign prostatic hypertrophy (BPH) is a common condition affecting men later in life, significantly impacting quality of life (QOL). Surgical intervention is often pursued when medical management fails, but...
INTRODUCTION: Benign prostatic hypertrophy (BPH) is a common condition affecting men later in life, significantly impacting quality of life (QOL). Surgical intervention is often pursued when medical management fails, but patient satisfaction with outcomes varies. Decisional regret can affect perceived success and patient satisfaction post-surgery. This study evaluates the relationship between post-surgical symptoms and decisional regret across BPH procedures. METHODS: A prospective, multicenter cohort study included 54 patients undergoing BPH surgery between March 2023 and February 2024. Patients completed the International Prostate Symptom Score-QOL (IPSS-QOL) scale preoperatively and at least three months postoperatively, along with the Decision Regret Scale (DRS). Surgical types included Urolift, Greenlight Laser, Rezum, Aquablation, and transurethral resection of the prostate (TURP). A DRS score of ≥25 indicated significant regret. Changes in IPSS-QOL were correlated with DRS scores (Spearman's rho), and subgroup comparisons were conducted using Mann-Whitney U tests. RESULTS: The average DRS score was 18.3, with 33% of patients reporting a DRS ≥25. Moderate correlations existed between quality of life (QOL) change (ρ = 0.34, p < 0.05) and total regret score. Minimally invasive surgical treatment (MISTs) patients demonstrated higher regret correlations than TURP. Lack of efficacy (75%), new symptoms (41%), and postoperative complications (25%) were the most common reasons for regret. CONCLUSION: While BPH surgery generally improves symptoms, a substantial portion of patients experience decisional regret. This underscores the importance of preoperative counseling to establish realistic expectations and reduce regret. Further research should explore strategies to enhance shared decision-making and align patient expectations with possible surgical outcomes.
Cryptic torsion: a case report of intra-abdominal supernumerary testicular torsion in a pediatric patient with normal descended testes.
Paradzinsky MG, Sharda M, Anvar AR … +1 more , Groth TW
Can J Urol · 2025 Jun · PMID 40567089 · Publisher ↗
Polyorchidism is a rare anomaly of the male urogenital tract characterized by the presence of one or more extra testes. Supernumerary testes can often present with coexistent conditions, including cryptorchidism, inguina...
Polyorchidism is a rare anomaly of the male urogenital tract characterized by the presence of one or more extra testes. Supernumerary testes can often present with coexistent conditions, including cryptorchidism, inguinal hernia, and torsion. We report a case of a pediatric patient with initial concern for intra-scrotal left testicular torsion on ultrasonography who was ultimately found to have torsion of an intra-abdominal supernumerary testis. He underwent scrotal exploration with bilateral orchiopexy and laparoscopic excision of the torsed gonad. This case highlights a unique presentation of polyorchidism with incongruent descent of an ipsilateral supernumerary testis.
Teapot ureterocystoplasty in posterior urethral valve and chronic kidney disease: a case report.
Ratnayake G, Jafar Y, Leslie B … +1 more , Braga LH
Can J Urol · 2025 Jun · PMID 40567088 · Publisher ↗
BACKGROUND: Bladder augmentation is frequently required to manage poorly compliant, low-capacity bladders resulting from posterior urethral valves (PUV). While traditional enterocystoplasty techniques are limited by comp...
BACKGROUND: Bladder augmentation is frequently required to manage poorly compliant, low-capacity bladders resulting from posterior urethral valves (PUV). While traditional enterocystoplasty techniques are limited by complications associated with bowel tissue use, ureterocystoplasty presents a favorable alternative in patients with concurrent megaureter. METHODS: We describe a novel teapot ureterocystoplasty technique that enhances ureteral vascular preservation by maintaining a 3 cm distal ureteral segment in its detubularized configuration. Postoperative outcomes demonstrated significant improvement, with cystographic bladder capacity increasing from 50 to 180 mL. Renal function stabilized following a transient creatinine elevation to 250 μmol/L. RESULTS AND CONCLUSION: At a 4.5-year follow-up, the patient continues to do well and has successfully avoided renal transplantation-an outcome commonly required for such pediatric cases.
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