Urology Journal[JOURNAL]
Sun
200 papers
A Regional Genetic Study of Primary Monosymptomatic Nocturnal Enuresis Using Chromosomal Microarray Analysis.
Yarali O, Naralan YS
Urol J · 2025 Oct · PMID 40914839 · Publisher ↗
PURPOSE: This study aimed to investigate the genetic heterogeneity of primary monosymptomatic nocturnal enuresis (PMNE) and assess potential genetic variants contributing to its etiology. MATERIALS AND METHODS: A total o...
PURPOSE: This study aimed to investigate the genetic heterogeneity of primary monosymptomatic nocturnal enuresis (PMNE) and assess potential genetic variants contributing to its etiology. MATERIALS AND METHODS: A total of 92 children aged 5-15 years with a positive family history of PMNE were evaluated. All patients underwent detailed urological and nephrological assessments to exclude organic causes. Genetic testing was performed using high-resolution chromosomal microarray technology to identify potential pathogenic variants. RESULTS: No pathogenic or likely pathogenic copy number variations were identified. A small number of patients exhibited variants of uncertain significance (VUS), none of which were conclusively linked to PMNE after parental segregation analysis. Our findings challenge previous studies that reported significant genetic markers and highlight the complex genetic architecture of PMNE. CONCLUSION: This study reinforces the genetic heterogeneity of PMNE and suggests it follows a polygenic and multifactorial inheritance pattern. Further research using whole-exome and whole-genome sequencing is needed to explore potential genetic contributors alongside environmental factors.
Effect of Monopolar Versus Bipolar Transurethral Resection of The Prostate on Erectile Function: A Randomized Controlled Trial with Phosphodiesterase-5 Inhibitors Users Subgroup Analysis.
Khorrami F, Sadat SM, Hajian M … +1 more , Gholipour F
Urol J · 2025 Nov · PMID 40914838 · Publisher ↗
PURPOSE: Men with lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) often experience erectile dysfunction (ED). While transurethral resection of the prostate (TURP) can improve ED, new onset ED...
PURPOSE: Men with lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) often experience erectile dysfunction (ED). While transurethral resection of the prostate (TURP) can improve ED, new onset ED remains a concern. This study compares monopolar (M TURP) and bipolar (B TURP) techniques, with a subgroup analysis based on phosphodiesterase 5 inhibitor (PDE5i) use. MATERIALS AND METHODS: This randomized clinical trial included candidates for TURP aged over 50 years. Patients were divided into M TURP and B TURP groups. Erectile function was assessed using the International Index of Erectile Function 15 (IIEF 15) at baseline, six weeks, and six months post surgery. RESULTS: A total of 205 patients were analyzed (102 M TURP, 103 B TURP). Baseline characteristics, perioperative findings, and surgical complications were similar. IIEF 15 scores were comparable between groups at all time points. In the PDE5i user subgroup, M TURP showed a slight short term decline in erectile function and total scores at 6 weeks, but both groups demonstrated no significant long term changes at 6 months. CONCLUSION: No significant difference was observed between M TURP and B TURP on erectile function during medium term follow up. Patients with prior PDE5i use may experience fewer short term adverse effects on erectile function from B TURP.
The Impact of Adjuvant Drug Therapy on Overall Survival in Patients with Clear Cell Renal Cell Carcinoma: A Systematic Review and Meta-Analysis.
Lan D, Du J, Yuan W … +3 more , Ying Q, Huang G, Lan J
Urol J · 2025 Nov · PMID 40914837 · Publisher ↗
PURPOSE: Clear cell renal cell carcinoma (ccRCC), the dominant subtype of renal malignancy, has a rising global incidence and mortality. While surgery is the standard of care for localized cases, adjuvant therapy aims to...
PURPOSE: Clear cell renal cell carcinoma (ccRCC), the dominant subtype of renal malignancy, has a rising global incidence and mortality. While surgery is the standard of care for localized cases, adjuvant therapy aims to improve outcomes in high-risk postoperative patients. To quantify the clinical value of adjuvant pharmacotherapy, this systematic review and meta-analysis assesses its effect on overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) in patients with ccRCC. MATERIALS AND METHODS: A comprehensive search of the Web of Science, Embase, Cochrane Library, and PubMed databases was conducted for articles published up to October 2024. The search used the English keywords "clear cell renal cell carcinoma," "adjuvant drug therapy," and "randomized controlled trials," combined with a free-word search. Randomized controlled trials (RCTs) assessing the effectiveness of at least one adjuvant drug therapy in patients with ccRCC were included. RESULTS: The meta-analysis showed that adjuvant drug therapy did not result in a statistically significant improvement for OS or PFS compared with the control group. There was also no statistically significant difference in DFS (P > 0.05). This systematic review provides evidence on the impact of adjuvant targeted therapy on OS, DFS, and PFS for patients with clear cell renal cell carcinoma. CONCLUSION: This study summarizes the effects of adjuvant drug therapy on OS, PFS, and DFS in ccRCC patients. The evidence from this meta-analysis can inform clinical decision-making, support risk stratification strategies, and encourage the integration of OS-driven endpoints in future trial designs, thereby providing valuable data for the treatment of ccRCC.
Screening of Relevant Genes and Signalling Pathways Affecting Adult Urosepsis: A Bioinformatic Analysis.
Shi XX, Rong LR, Wei HZ
Urol J · 2025 Oct · PMID 40914836 · Publisher ↗
PURPOSE: The cellular and molecular pathophysiology of urosepsis, a condition caused by a urinary tract infection spreading to the bloodstream, involves complex epigenetic behavior. The objective of this study was to ide...
PURPOSE: The cellular and molecular pathophysiology of urosepsis, a condition caused by a urinary tract infection spreading to the bloodstream, involves complex epigenetic behavior. The objective of this study was to identify relevant genes and signaling pathways in adult urosepsis through a bioinformatic analysis of differentially expressed genes (DEGs). MATERIALS AND METHODS: In this in silico study, the GSE69528 dataset, containing 138 total RNA blood samples from patients with sepsis and uninfected controls, was obtained from the Gene Expression Omnibus (GEO) database. Microarray data were analyzed using GEO2R tools and R software. DEGs were identified using a fold change (FC) cutoff of > 1.5 or < 0.67 and a significance level of p < 0.05. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to determine the enriched pathways of DEGs before constructing protein-protein interaction (PPI) networks with STRING and Cytoscape. RESULTS: A total of 108 DEGs were identified, comprising 67 upregulated and 41 downregulated genes. GO and KEGG analyses revealed that these DEGs were significantly enriched in pathways such as the complement and coagulation cascade, neutrophil degranulation, negative regulation of interferon-gamma response, T-cell activation, and granulocyte differentiation. The PPI network analysis identified 67 nodes with 110 interactions, from which CEACAM8, MPO, and RETN were identified as hub genes. Overexpression of CEACAM8 and MPO and suppression of RETN may be associated with a better disease prognosis. CONCLUSION: The identified hub genes-CEACAM8, MPO, and RETN-are predicted to be significant biomarkers in the prognosis and progression of sepsis. These genes could be targeted for the discovery of new therapeutic drugs for treating and managing urosepsis.
Preliminary Functional Outcome Following Robotic Intracorporeal Orthotopic Ileal Neobladder with Integrated Pelvic Fascial Structure-Sparing in Males with Bladder Cancer.
Xu X, Liang Z, Feng Y … +4 more , Qi H, Wang S, Xia D, Wang P
Urol J · 2025 Nov · PMID 40914835 · Publisher ↗
PURPOSE: To describe our integrated pelvic fascial structure-sparing (IPFSS) technique for robotic-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder (ONB) reconstruction and to evaluate its imp...
PURPOSE: To describe our integrated pelvic fascial structure-sparing (IPFSS) technique for robotic-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder (ONB) reconstruction and to evaluate its impact on urinary continence and sexual function in male patients. METHODS: This retrospective observational study was conducted at a single high-volume center. Male bladder cancer patients who underwent IPFSS RARC with ONB were included. Demographic, clinical, and pathological data were collected. Functional outcomes were evaluated and compared with a cohort of patients who underwent conventional non-nerve-sparing RARC. RESULTS: Thirty-six patients were included in the IPFSS group and 42 in the conventional group. RARC with intracorporeal urinary diversion was successfully completed in all patients without open conversion. The mean total operative time was 387.9 minutes in the IPFSS group and 392.0 minutes in the conventional group (p = 0.465). At 3 months post-surgery, 30 patients (83%) in the IPFSS group achieved daytime continence (0-1 pads), compared to 14 patients (33%) in the conventional group. By 6 months, daytime continence increased to 35 patients (97%) in the IPFSS group, while 28 patients (67%) in the conventional group achieved similar results. At 6 months, 30 patients (83%) in the IPFSS group reported full potency with or without phosphodiesterase type 5 (PDE5) inhibitors, compared to only 3 patients (7%) in the conventional group. CONCLUSION: We present a feasible surgical technique for RARC that involves holistic preservation of the pelvic fascial architecture. This approach is associated with a rapid recovery of daytime continence and sexual function in male patients.
Update on Suprapubic Cystostomy Diversion vs. Primary Realignment for the Management of Blunt Posterior Urethral Injuries: A Systematic Review and Meta-Analysis.
Wen JH, Jiang SJ
Urol J · 2025 Aug · PMID 40849733 · Publisher ↗
PURPOSE: This paper reviewed studies comparing the effectiveness of primary urethral realignment (PUR) and suprapubic cystostomy diversion (SCD) in the early treatment of blunt posterior urethral injuries (PUI). MATERIAL...
PURPOSE: This paper reviewed studies comparing the effectiveness of primary urethral realignment (PUR) and suprapubic cystostomy diversion (SCD) in the early treatment of blunt posterior urethral injuries (PUI). MATERIALS AND METHODS: We conducted a systematic review of original studies that directly compared the incidence of urethral strictures (US), urinary incontinence (UI), and erectile dysfunction (ED) in patients receiving primary management for pelvic fracture posterior urethral injuries with PUR versus SCD. We used Review Manager 5.3 for statistical analysis. RESULTS: The initial search yielded 205 articles, and 14 met the inclusion criteria for the final systematic review. Meta-analysis showed that PUR was significantly more effective than SCD in reducing the proportion of US in the 365 and 335 cases of PUR and SCD, respectively (OR 0.09, 95% CI 0.04-0.22, p < 0.0001). However, there was no significant difference between PUR and SCD in the incidence of UI (OR 0.60, 95% CI 0.33-1.11) or ED (OR 0.70, 95% CI 0.45-1.11). CONCLUSION: PUR is more effective than SCD in reducing the incidence of US in patients with pelvic fracture posterior urethral injuries. However, there was no significant difference between PUR and SCD in the incidence of UI or ED.
Effect of Spinal and General Anesthesia on Postoperative Pain and Satisfaction in Ureteroscopic Lithotripsy (URSL).
Tavoosian A, Shamshirgaran A, Hosseini SR … +2 more , Alaedini F, Aghamir SMK
Urol J · 2025 Nov · PMID 40684277 · Publisher ↗
PURPOSE: To compare general anesthesia (GA) with spinal anesthesia (SA) regarding postoperative pain and satisfaction after ureteroscopic lithotripsy (URSL). MATERIALS AND METHODS: Two hundred twenty-nine patients were a...
PURPOSE: To compare general anesthesia (GA) with spinal anesthesia (SA) regarding postoperative pain and satisfaction after ureteroscopic lithotripsy (URSL). MATERIALS AND METHODS: Two hundred twenty-nine patients were analyzed in the study. Patients were assigned to two groups-SA and GA. Demographic data, stone characteristics, operation time, and frequency of opioid analgesic use during the admission period were collected from hospital medical records. Visual analogue scale (VAS) scores at 6 hours and 24 hours after URSL were recorded. Complications according to the Clavien-Dindo classification and the experience of headaches after surgery (Yes/No) were documented after one month. Participants and surgeons were asked to rate their satisfaction on a scale of 1 to 10. RESULTS: Of 237 eligible patients, 229 completed the study. The incidence of headaches and VAS scores (at 6 h and 24 h) were significantly higher in the SA group (P < 0.001). Patient and surgeon satisfaction in the GA group were significantly higher (P < 0.001). Multivariate analysis showed that female sex was associated with lower opioid analgesic use during the admission period (odds ratio [OR] = 0.47), and surgery time correlated with frequency of opioid use and headache (OR = 1.12 and OR = 1.11, respectively). CONCLUSION: GA was associated with better postoperative pain control after URSL and higher satisfaction levels for both surgeons and patients.
Predictive Value of Systemic Inflammatory Markers in the Prognosis of Prostate Cancer with Variant Histology.
Ates HA, Aktas S, Araci MHE … +3 more , Okucu E, Yalcin B, Koseoglu H
Urol J · 2025 Oct · PMID 40684276 · Publisher ↗
OBJECTIVE: This study aimed to investigate the potential role of systemic inflammatory markers in the management of Prostate Cancer (PCA) with variant pathology. MATERIALS AND METHODS: A retrospective analysis was conduc...
OBJECTIVE: This study aimed to investigate the potential role of systemic inflammatory markers in the management of Prostate Cancer (PCA) with variant pathology. MATERIALS AND METHODS: A retrospective analysis was conducted on 302 patients who underwent radical prostatectomy between 2014 and 2023. After applying exclusion criteria, 279 patients were included: 207 with adenocarcinoma and 72 with variant pathologies. Systemic inflammatory markers such as Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), and Systemic Inflammation Response Index (SIRI) were compared between the groups. RESULTS: Patients in the variant group were significantly older (p = 0.005). The frequencies of lymphovascular invasion (LVI), perineural invasion (PNI), and positive surgical margins (SM) were significantly higher in the variant histology group (p < 0.001, p = 0.014, and p < 0.001, respectively), as were ISUP grades (p < 0.001). Pretreatment PSA values were also significantly higher in the variant group (p < 0.001), as was the rate of subsequent radiotherapy (p < 0.001). However, no significant differences were found in NLR, PLR, SIRI, or SII values between the groups. Recurrence rates were significantly higher in the variant group (p < 0.05), but overall mortality did not differ. CONCLUSION: Systemic inflammation markers have limited value in predicting prognosis among patients with variant PCA. This highlights the complex role of inflammation in cancer progression and underscores the need for further research to identify more specific biomarkers for different PCA variants.
Efficacy of Low-Frequency Acupuncture Therapy Based on the Midnight-Noon Ebb-Flow Concept for Central Neurogenic Bladder: A Randomized Controlled Trial.
Wang Z, Zhou X, Liu X … +3 more , Xia Y, Zhou Y, Luo L
Urol J · 2025 Oct · PMID 40684275 · Publisher ↗
PURPOSE: This study aims to investigate the therapeutic efficacy and complications of low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept in central neurogenic bladder (CNB). MATERIALS AND METHO...
PURPOSE: This study aims to investigate the therapeutic efficacy and complications of low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept in central neurogenic bladder (CNB). MATERIALS AND METHODS: This study was a prospective, randomized controlled trial. Sixty patients diagnosed with CNB without prior treatment were randomly divided into two groups: the control group (n = 30) was treated with basic rehabilitation training, and the treatment group (n = 30) was treated with basic rehabilitation training plus low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept for 4 weeks. The fixed acupuncture points selected were: Sanyinjiao (bilateral), Zhongji (unilateral), and Diji (unilateral). The study compared pre- and post-treatment clinical curative effects, urodynamic indicators, urination status, the Neurogenic Bladder Symptom Score (NBSS), the Urinary Symptom Distress Scale (USDS), the World Health Organization Quality of Life Brief Inventory (WHOQOL-BREF), and the occurrence of adverse reactions and complications between the two groups. RESULTS: The overall efficacy rate of 96.67% in the treatment group was significantly higher than that in the control group (86.67%) (P < 0.05). After treatment, the MBC, MFR, Pdet, DASUV, and WHOQOL-BREF scores significantly increased, while the RUV, DUF, DAUL, NBSS and USDS scores all decreased in both groups, with the treatment group showing significantly better results than the control group (P < 0.05). There was no statistically significant difference in adverse reactions and complication rates between the two groups (P > 0.05). CONCLUSION: Low-frequency acupuncture therapy based on the Midnight-Noon Ebb-Flow concept significantly improves bladder function and alleviates urinary difficulties in CNB, demonstrating good safety and considerable clinical applicability.
Outpatient Percutaneous Nephrolithotomy, An Interesting Option: A Systematic Review.
Bourgi A, Ayoub E, Bruyere F
Urol J · 2025 Sep · PMID 40684274 · Publisher ↗
PURPOSE: The prevalence of kidney stone disease and associated events is rising, with modern surgical approaches emphasizing minimally invasive techniques like ambulatory percutaneous nephrolithotomy (PCNL). This strateg...
PURPOSE: The prevalence of kidney stone disease and associated events is rising, with modern surgical approaches emphasizing minimally invasive techniques like ambulatory percutaneous nephrolithotomy (PCNL). This strategy offers potential benefits such as reduced costs, improved efficiency, and high patient satisfaction. However, its safety and feasibility require further evaluation. METHODS: A systematic review was conducted following PRISMA guidelines. Databases including PubMed, Embase, Scopus, and the Cochrane Library were searched for studies on ambulatory PCNL published between 1986 and 2024. Out of 2381 identified studies in the initial pool, 17 met the inclusion criteria. Data were analyzed regarding patient selection, technical modifications, surgical outcomes, and complications. RESULTS: The review included 456 patients undergoing 459 procedures. Ambulatory PCNL was feasible for highly selected patients meeting strict criteria (ASA <3, BMI <35 kg/m², no major comorbidities, and minimal stone burden). Mean operative time was 103 minutes, with an average hospital stay of 6.4 hours. The procedure achieved a 93% stone clearance rate, with 15% experiencing mild complications (Clavien-Dindo grade 1-2) and 4.6% readmissions. Severe complications (grade 3-4) were rare (0.4%). CONCLUSION: Ambulatory PCNL is a safe, efficient option for select patients, optimizing healthcare resources and improving patient outcomes. Wider adoption requires standardized protocols and multicenter studies to expand its application.
Retrospective Analysis of Surgical Outcomes Following Scarless Orchiopexy via Either Scrotal Incision or Single-Site Transumbilical Laparoscopy.
Zhang C, Tian Q, Zhao X … +5 more , Yu K, Cao P, Niu Y, Zhou X, Li N
Urol J · 2025 Oct · PMID 40684273 · Publisher ↗
PURPOSE: The surgical approach to pediatric cryptorchidism has traditionally been the inguinal pathway. However, that has changed with the increased use of scrotal incision and single-site transumbilical laparoscopy, bot...
PURPOSE: The surgical approach to pediatric cryptorchidism has traditionally been the inguinal pathway. However, that has changed with the increased use of scrotal incision and single-site transumbilical laparoscopy, both of which result in a scarless surgical incision. We aimed to review our experience with the combined utilization of these two methods for the treatment of pediatric cryptorchidism and evaluate the surgical outcomes. MATERIALS AND METHODS: This retrospective case series included 267 children who underwent scarless orchiopexy between January 2019 and December 2022. Data were gathered from case and operative records. Testicular retraction, testicular atrophy, other complications, cosmetic outcomes, and parental satisfaction were evaluated. RESULTS: A total of 267 children (aged 1-7.4 years, median 1.8 years) with palpable and nonpalpable undescended testes underwent scarless orchiopexy at our center. Among them, 58 (21.7%) were treated with a scrotal incision and 209 (78.3%) underwent single-site transumbilical laparoscopic surgery. The follow-up period ranged from 6 to 53 months, with an average of 26.2 months. During the follow-up period, testicular retraction (4 cases, 1.5%) and atrophy (5 cases, 1.9%) occurred in the laparoscopic group. One child in the laparoscopic group developed a hydrocele but recovered after 3 months. In most cases (98.9%), the scars were invisible, indicating an excellent cosmetic effect. CONCLUSION: The combination of scrotal incision and transumbilical laparoscopic orchiopexy can resolve cryptorchidism in children at different locations and achieve successful outcomes with a low rate of postoperative complications and good cosmetic results.
Effects of 6-Gingerol Supplementation in Cryopreservation on Human Sperm Parameters, DNA Fragmentation, and Apoptosis Incidence.
Zekri S, Bahiraei R, Ghezelayagh Z … +4 more , Maghami P, Shahverdi A, Sabbagian M, Ebrahimi B
Urol J · 2025 Nov · PMID 40684272 · Publisher ↗
PURPOSE: Sperm cryopreservation is a valuable method for fertility preservation in men who suffer from oligozoospermia and cancer. The increase in oxidative stress during this process negatively affects sperm viability,...
PURPOSE: Sperm cryopreservation is a valuable method for fertility preservation in men who suffer from oligozoospermia and cancer. The increase in oxidative stress during this process negatively affects sperm viability, membrane fluidity, and function. Supplementation of antioxidants to the cryopreservation medium can reduce these negative effects. This study investigated the effects of 6-gingerol as a natural antioxidant during human sperm cryopreservation on different sperm parameters, DNA fragmentation, and apoptosis. MATERIALS AND METHODS: In this experimental study, semen samples were obtained from 42 normozoospermic men referred to the Royan Institute. The samples were randomly divided into fresh, control (cryopreservation), and gingerol (cryopreservation with 6-gingerol) groups. Sperm evaluations were conducted before and after cryopreservation. Sperm parameters, DNA fragmentation index (DFI), caspase-3 activity, reactive oxygen species (ROS) levels, malondialdehyde (MDA) concentration, and total antioxidant capacity (TAC) levels were assessed. RESULTS: Use of 6-gingerol in the cryopreservation medium resulted in recovery of a significantly higher proportion of viable sperm post-cryopreservation compared with the control group (64.1 ± 1.3% vs 56.4 ± 1.3%; P = 0.000). ROS levels were significantly lower (P = 0.000), and the percentage of sperm with intact membrane potential was significantly higher (P = 0.000) in the gingerol group (26.1 ± 0.1 RLU/s; 63.5 ± 1.4%) compared with the control group (32.1 ± 0.7 RLU/s; 53.3 ± 1.5%). Active caspase-3 (P = 0.007) and DFI (P = 0.008) were lower in the gingerol group (47.3 ± 3.6%; 37.9 ± 1.3%, respectively) compared with the control group (60.5 ± 3.6%; 42.1 ± 0.1%, respectively), though the differences for caspase-3 and DFI did not reach statistical significance where indicated by the authors. CONCLUSION: Supplementation of the sperm cryopreservation medium with 6-gingerol could improve sperm quality and function and positively affect the degree of apoptosis during sperm freezing.
Evaluation of the Effectiveness of Dynamic Neuromuscular Stabilization Training in Children Diagnosed with Lower Urinary Tract Dysfunction and Comparison with EMG Biofeedback Treatment: A Pilot Study.
Nacar E, Suner Keklik S, Elmas AT
Urol J · 2025 Nov · PMID 40684271 · Publisher ↗
PURPOSE: This study was designed to evaluate the effectiveness of dynamic neuromuscular stabilization (DNS) training in children with non neurogenic lower urinary tract dysfunction (LUTD) and compare it with biofeedback...
PURPOSE: This study was designed to evaluate the effectiveness of dynamic neuromuscular stabilization (DNS) training in children with non neurogenic lower urinary tract dysfunction (LUTD) and compare it with biofeedback (BF) treatment. MATERIALS AND METHODS: A total of 15 participants aged 6-15 years with non neurogenic LUTD were divided into three groups: Group I, DNS exercise training; Group II, BF training; and Group III, DNS plus BF training. Dysfunctional Voiding and Incontinence Scoring System (DVISS) scores, uroflowmetry parameters, uroflow curve, post void residual (PVR) values, and deep trunk muscle strength were evaluated at baseline and at 4, 8, and 12 weeks after treatment. RESULTS: Total DVISS scores significantly decreased after 12 weeks in Groups I and III, while Group II showed significant decreases at 4 and 8 weeks (P < .05). Improvements in deep trunk muscle strength at 4 and 8 weeks were significantly greater in Groups I and III than in Group II (P < .05). In Group I, average flow rate increased at 4 weeks and flow time decreased at 12 weeks (P < .05). PVR decreased significantly at 12 weeks in Group I and at 8 weeks in Group III (P < .05). CONCLUSION: DNS and BF training are effective in improving symptoms in patients with non neurogenic LUTD; however, groups receiving DNS exercises were superior for several parameters.
High Uric Acid Decrease the Number of Erections in Night: A Propensity Score-Matched Analysis.
Wang S, Zhang A, Niu S … +2 more , Pan Y, Liu X
Urol J · 2025 Sep · PMID 40201939 · Publisher ↗
BACKGROUND: Metabolic syndrome is considered a risk predictor for erection dysfunction (ED). However, the effect of serum uric acid (UA) on the development of ED is little known. METHODS: We adopt propensity score matchi...
BACKGROUND: Metabolic syndrome is considered a risk predictor for erection dysfunction (ED). However, the effect of serum uric acid (UA) on the development of ED is little known. METHODS: We adopt propensity score matching analysis (PSM) to adjust multitudinous confounding factors such as age, metabolic syndrome, sex hormone and some blood measurements. The members of the normal UA and high UA participator were matched at a 1:1 ratio by propensity score. And we used two diagnostic methods IIEF-5 and nocturnal penile tumescence and rigidity (NPTR) to assess and diagnose ED. RESULTS: Before PSM, total 120 participators were included, compared with participants with normal serum UA (n=61), those with high serum UA(n=59) had statistic difference in some baseline information (BMI 27.8 ± 7.4 vs 24.4 ± 5.1 kg/m2, p = 0.004; TG 2.1 ± 1.8 vs 1.5 ± 0.9 mmol/L, p = 0.015; creatinine 70.5 ± 9.9 vs 66.3 ± 10.7 umol/L, p = 0.03; T 450.9 ± 181.0 vs 598.2 ± 186.3 ng/dL, p < 0.001). After PSM, total 82 participators were included, with high level of serum UA (n = 41, Group A) and normal serum UA (n = 41, Group B). On the result of IIEF-5, 40 of 41 participants (97.6.0%) with high UA diagnosed ED, whereas 39 of 41 participants (95.1%) with normal UA diagnosed ED, the incidence has no statistical significance between two groups (p > 0.999). On the result of NPTR, the mean number of erections in Group A was 4.1 ± 2.0, was significantly less than the same parameter in Group B (5.3 ± 1.9, p = 0.004); 9 of 41 participants (22.0%) with high UA develop ED, whereas 14 of 41 participants (34.1%) with normal UA develop ED, the incidence has no statistical significance between Group A and Group B (p = 0.326). CONCLUSION: Our study revealed that high UA did decrease the number of erections in night, which was diagnosed by NPTR. High uric acid may be a potential risk factor for ED and more large studies are needed.
Comparison of the Efficacy of Ureteroscopy through a Flexible Vacuum-Assisted Ureteral Access Sheath with Tubeless-mini Percutaneous Nephrolithotomy for the Treatment of 3-2 cm Renal Calculi.
Deng G, Jiang K, Wang Q … +3 more , Lu W, Huang K, Sun F
Urol J · 2025 Nov · PMID 40201938 · Publisher ↗
PURPOSE: To investigate the efficacy of the flexible vacuum-assisted ureteral access sheath (FV-UAS) combined with disposable flexible ureteroscope (FURS) versus tubeless-mini percutaneous nephrolithotomy (T-PCNL) in the...
PURPOSE: To investigate the efficacy of the flexible vacuum-assisted ureteral access sheath (FV-UAS) combined with disposable flexible ureteroscope (FURS) versus tubeless-mini percutaneous nephrolithotomy (T-PCNL) in the treatment of renal calculi with a diameter of 2-3 cm. MATERIALS AND METHODS: This retrospective analysis included 270 patients with renal calculi with a maximum diameter of 2-3 cm treated between January 2022 and July 2024. Of these, 146 cases were treated with single-use ureteroscopic lithotripsy through an FV-UAS, while 124 cases were treated by tubeless PCNL (T-PCNL group) through a 16F Amplatz sheath. Perioperative indicators and postoperative stone-free rates (SFRs) were compared. RESULTS: There was no significant difference in the stone-free rates (SFRs) between the two surgical methods. Using the criterion of a residual kidney stone diameter less than 4 mm, the SFRs at 3 days postoperatively were compared between the two groups: 95% confidence interval (CI), 0.56-2.28; odds ratio (OR) = 1.13; P = .724. The SFRs at 1 month postoperatively were: 95% CI, 0.417-2.60; OR = 1.041; P = .931. Using the criterion of a residual kidney stone diameter less than 2 mm, the SFRs at 3 days postoperatively were: 95% CI, 0.355-1.055; OR = 0.612; P = .076; the SFRs at 1 month postoperatively were: 95% CI, 0.374-1.320; OR = 0.703; P = .271. There was no significant difference in the incidence of systemic inflammatory response syndrome (SIRS) and the need for postoperative analgesia between the two groups (P = .813 and P = .839, respectively). The surgical duration in the FV-UAS group was significantly longer (P < .001). The decrease in postoperative hemoglobin (Hb) levels and hospital stay in the FV-UAS group were significantly lower than those in the T-PCNL group (both P < .001). CONCLUSION: For treating 2-3 cm renal calculi, both FV-UAS with disposable ureteroscope and 16F tubeless PCNL yield high stone-free rates. FV-UAS-assisted FURS reduces bleeding and hospital stay, whereas 16F tubeless PCNL shortens surgery duration.
Improved Graft Function and Decreased Post-transplantation Urinary Tract Infection after Azithromycin Dosing to Donors: A Pilot Study.
Teimoori M, Mokhtari G, Falahatkar S … +3 more , Khosravi M, Momeni Moghaddam M, Taheri Z
Urol J · 2025 Mar · PMID 40057833 · Publisher ↗
PURPOSE: The rising trend of End-stage Renal Disease (ESRD) patients requiring dialysis or transplantation needs a more therapeutic plan. As the best strategy for ESRD patients, kidney transplantation still needs outcome...
PURPOSE: The rising trend of End-stage Renal Disease (ESRD) patients requiring dialysis or transplantation needs a more therapeutic plan. As the best strategy for ESRD patients, kidney transplantation still needs outcome improvement. Macrolide drugs display antimicrobial and anti-inflammatory properties in chronic disease and intraoperatively and can concentrate in tissues for extended periods. Hence, theoretically, the drug prescription to the donor and accumulation in the kidney can cause graft immunomodulation and improve kidney transplantation outcomes. METHODS AND ANALYSIS: This double-blinded randomized clinical trial was conducted on 62 eligible kidney donors randomly allocated to the azithromycin or placebo group and treated with a single dose (one gram) one day before surgery. The primary outcome was kidney graft function, and secondary outcomes included rejection rate, urinary tract infections in graft recipients, pain and systemic inflammatory response syndrome in live donors, and complications in donors and recipients. Outcomes were measured at baseline and every day in the first week after transplantation in both live donors and recipients and 30 and 90 days after transplantation. The adverse events were recorded as well. RESULT: The mean age was 39 (SD, 13) years; 40% were women, and 11.6% were diabetic. Mean creatinine was 6.11 mL/min/1.73m2. Most patients in both arms were male (61.3%) and in early middle age. Hypertension was the most common cause of ESRD. Azithromycin could reduce the rejection rate in the first few days after kidney transplantation. Inflammatory mediators were lower in the azithromycin group, and fewer cases of urinary tract infection were found in the azithromycin group (p < 0.05). CONCLUSION: Azithromycin reduces adverse outcomes and enhances graft function. It would offer an intervention that is easy to use and economical, lowering post-transplant risks.
Predictive Urodynamic Parameters for The Treatment Efficacy of Onabotulinum Toxin A in Neurogenic Lower Urinary Tract Dysfunction.
Baturu M, Bayrak Ö, Yaşar Y … +2 more , Başgut Ö, Seçkiner İ
Urol J · 2025 Mar · PMID 40057832 · Publisher ↗
PURPOSE: To evaluate urodynamic parameters that may serve as predictors of treatment efficacy with Onabotulinumtoxin-A (onaBoNT-A) in patients with neurogenic lower urinary tract dysfunction (NLUTD). MATERIALS AND METHOD...
PURPOSE: To evaluate urodynamic parameters that may serve as predictors of treatment efficacy with Onabotulinumtoxin-A (onaBoNT-A) in patients with neurogenic lower urinary tract dysfunction (NLUTD). MATERIALS AND METHODS: Patients with NLUTD who received 200 IU onaBont-A injections were included in the study. Urodynamic parameters and the correlations between these parameters and treatment outcomes were analyzed. The primary endpoints were changes in the daily pad usage, and the secondary endpoint was to demonstrate the relationship between duration of treatment efficacy of onabotulinumtoxin-A with preoperative urodynamic parameters in patients with NLUTD. RESULTS: The data of 74 patients were analyzed retrospectively, and 66 (89%) patients benefited from onaBoNT-A treatment. A negative correlation was observed between the number of pads changed per day and maximum cystometric capacity (MCC) (p = 0.024, r = -0.277). A positive correlation existed between the duration of treatment efficacy of onaBoNT-A and change in detrusor pressure during filling cystometry (ΔPdet) (p = 0.018, r = 0.291), whereas a negative correlation was noted with bladder compliance (p = 0.035, r = -0.260). Any additional indicator of its urodynamic efficacy showing a correlation with the number of pads changed per day has not been identified yet. CONCLUSION: OnaBoNT-A injections effectively manage NLUTD, with MCC being a potential predictor of treatment response. Other urodynamic parameters showed limited predictive value. Patients with lower MCC experienced greater improvements in reducing the number of pads used following treatment. High ΔPdet and low bladder compliance were associated with treatment benefits persisting for longer periods of time.
The Impact of Plasmakinetic Resection and Conventional Transurethral Resection of the Prostate on Clinical Symptoms and Quality of Life in Patients with Benign Prostatic Hyperplasia: Retrospective Cohort Study.
Gong C, Zou S, Cui S
Urol J · 2025 Mar · PMID 40057831 · Publisher ↗
PURPOSE: Benign prostatic hyperplasia (BPH) is a condition commonly observed in elderly males, leading to lower urinary tract symptoms and potential complications. Surgical procedures primarily include transurethral rese...
PURPOSE: Benign prostatic hyperplasia (BPH) is a condition commonly observed in elderly males, leading to lower urinary tract symptoms and potential complications. Surgical procedures primarily include transurethral resection of the prostate (TURP) and plasmakinetic resection, with their effectiveness under active research and clinical interest. MATERIALS AND METHODS: This retrospective cohort study compared the impacts of plasmakinetic resection and conventional TURP on clinical symptoms and quality of life in patients with benign prostatic hyperplasia. It encompassed surgical duration, postoperative complications, urodynamic parameters, quality of life scores, sexual function, and long-term outcomes. RESULTS: Postoperative symptom improvements, including International Prostate Symptom Score (IPSS) and Quality of Life (QoL) score, were significantly higher in the plasmakinetic resection group (P = 0.033 and P = 0.003, respectively). Urodynamic parameters such as peak flow rate (P = 0.008), post-void residual volume (P = 0.044), and Qmax (P = 0.012) also showed significant improvements. Quality of life assessments, including (EuroQol-5 Dimensions)EQ-5D scores (P = 0.003), general health perception (P = 0.009), sexual function (P = 0.011), and overall satisfaction (P = 0.004) favored plasmakinetic resection. Plasmakinetic resection resulted in better outcomes for continence and sexual function. Long-term outcomes at 1 year post-operation, including IPSS scores (P = 0.006) and overall satisfaction (P = 0.002), were significantly better in the plasmakinetic resection group. No significant differences were observed in health care resource utilization. CONCLUSION: The study suggests that plasmakinetic resection offers advantages over conventional TURP in symptom relief, quality of life, continence, sexual function, and long-term results for patients with BPH.
Laparoscopic Management of the Urinary Stones.
Pakmanesh H
Urol J · 2025 Mar · PMID 40057830 · Publisher ↗
Laparoscopic stone surgery was historically recommended only for cases involving concomitant ureteropelvic junction obstruction (UPJO), congenital abnormalities, or when other endourological procedures had failed as an a...
Laparoscopic stone surgery was historically recommended only for cases involving concomitant ureteropelvic junction obstruction (UPJO), congenital abnormalities, or when other endourological procedures had failed as an alternative to open surgery. However, recent randomized clinical trials and meta-analyses involving patients with normal anatomy and large renal stones have shown that laparoscopic pyelolithotomy (LPL) has a higher success rate and lower complication rates compared to the gold standard, percutaneous nephrolithotomy (PCNL). Furthermore, stone recurrence appears to be lower following LPL compared to PCNL. Therefore, we suggest that current guidelines for stone treatment reconsider laparoscopy as an effective primary treatment for large kidney stones, rather than simply viewing it as an alternative option. Nonetheless, careful case selection and the surgeon's experience are critical for the success of this treatment.
Impact of Positive Surgical Margins on Recurrence and Overall Survival Following Partial Nephrectomy: A Systematic Review and Meta-Analysis.
Omrani M, Basiri A, Rahimlou M
Urol J · 2025 Jan · PMID 39741400 · Publisher ↗
PURPOSE: Positive surgical margins (PSM) following partial nephrectomy (PN) for renal cell carcinoma (RCC) are a concern due to potential implications for recurrence and survival. This systematic review and meta-analysis...
PURPOSE: Positive surgical margins (PSM) following partial nephrectomy (PN) for renal cell carcinoma (RCC) are a concern due to potential implications for recurrence and survival. This systematic review and meta-analysis assess the impact of PSM on recurrence rates and progression-free survival in RCC patients. METHODS: We conducted a systematic search of PubMed, Embase, Scopus, Cochrane, and Web of Science databases from inception through July 2024. Studies examining recurrence and survival outcomes in RCC patients with and without PSM post-PN were included. A random-effects model was applied to calculate pooled hazard ratios (HR) and 95% confidence intervals (CI) for recurrence and survival. RESULTS: Thirty studies met the inclusion criteria. Our analysis showed that PSM was significantly associated with a higher risk of local recurrence (HR = 2.13, 95% CI: 1.67-2.72) and a lower recurrence/progression-free survival (HR = 1.70, 95% CI: 1.40-2.07) compared to negative surgical margins. Subgroup analyses indicated consistent results across study designs and RCC histologic subtypes. CONCLUSION: The presence of PSM following PN for RCC is associated with a 2.13-fold increase in local recurrence and a 1.7-fold reduction in progression-free survival, emphasizing the need for precise margin management during surgery. These findings highlight the importance of optimizing surgical techniques and considering adjuvant treatment strategies for patients with PSM to improve oncologic outcomes.
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