PURPOSE It has been suggested that patients with Posterior Urethral Valves (PUV) and a solitary functioning kidney (SFK) have poorer mid-term and long-term renal function than those with 2 functioning kidneys (2FK). We compared mid-term eGFR of PUV patients with and without solitary kidneys. MATERIAL AND METHODS We used the CIRCUP randomized controlled trial database, which included only patients with

PURPOSE No clear guidelines exist regarding MRI use after confirmatory biopsy during active surveillance (AS). Our objective was to evaluate MRI performance after confirmatory biopsy in patients with vs. without prior MRI-informed biopsy. METHODS Patients in Canary PASS with Gleason grade group (GG) 1 disease undergoing MRI-informed Biopsy 2, defined as second surveillance biopsy after diagnosis, were

PURPOSE Genitourinary syndrome of menopause (GSM) describes the symptoms and physical changes that result from declining estrogen and androgen concentrations in the genitourinary tract during the menopausal transition. There has not been a consensus reached about the number or type of symptoms needed to diagnose GSM, and the associated urinary symptoms are also linked with other common urologic conditions

PURPOSE Adjuvant immunotherapy for clear cell renal cell carcinoma (ccRCC) is controversial because of the absence of reliable biomarkers for identifying patients most likely to benefit. The aim of this study was to develop and validate a quantitative radiomics signature (RS) and a radiomics clinical model to identify patients at increased risk of recurrence after surgery among those eligible for adjuvant

PURPOSE With the availability of PSMA-PET scans, it is controversial whether pelvic lymph-node dissection (PLND) at time of radical prostatectomy (RP) is still the most reliable and accurate staging modality for lymph-node assessment. Furthermore, the oncological benefit of PLND remains unclear. Aim of this study was to assess whether omitting PLND in patients undergoing RP for prostate cancer is associated

PURPOSE To evaluate the efficacy of low-energy extracorporeal shockwave therapy (LI-SWT) compared with a sham treatment in improving erectile function in men after radical prostatectomy. Erectile function was assessed using the Erection Hardness Score (EHS) and International Index of Erectile Function (IIEF) at baseline and 4, 12, and 24 weeks after treatment. MATERIALS AND METHODS A total of 75 participants

PURPOSE The efficacy of ureteroscopy to treat urinary stones is often less than 60%. Acoustic Enhancer is an investigational device of microparticles with a tag designed with an affinity for calcium. We evaluated safety and efficacy of ureteroscopic laser lithotripsy with and without Acoustic Enhancer Microbubble Cavitation in a randomized clinical trial. MATERIALS AND METHODS Patients with urolithiasis

OBJECTIVE To investigate the role of prophylactic antibiotics after robot-assisted radical cystectomy (RARC) in the prevention of 90-day urinary tract infections (UTIs). METHODS Patients who underwent RARC with urinary diversion were randomized to standard of care (SOC) versus receiving prophylactic antibiotics (Nitrofurantoin 100 mg daily or trimethoprim/sulfamethoxazole 160/800 mg daily) for 30 days

PURPOSE Active surveillance (AS) is an alternative to primary intervention (PI) in the management of small renal masses (SRMs; clinical stage T1a). However, AS remains underutilized due to a lack of strong, prospective data. We herein report mature outcomes after a twelve-year experience with the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry. MATERIALS AND METHODS Multi-institutional

PURPOSE We aimed to determine if, using baseline MRI-guided biopsy (MRGB), durability of active surveillance (AS) could be predetermined, follow-up biopsies avoided, and if by incorporating focal therapy (FT), AS extended. MATERIALS AND METHODS A cohort of 869 men in the University of California, Los Angeles, protocol study of AS (2010-2022) was analyzed. Inclusion criteria were baseline MRGB showing

PURPOSE This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part I of a three-part series focusing on the evaluation of such patients. The presentation of these men is widely variable. In addition to pelvic pain, they may also have pain in many body areas outside of the pelvis. The wide variety of clinical presentations

PURPOSE This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part III of a three-part series focusing on treatment of chronic scrotal content pain (CSCP). CSCP patients typically present with pain described in the testes with tenderness in the epididymis and/or spermatic cord. Patient education of the underlying etiology

PURPOSE This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part II of a three-part series focusing on treatment of chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS). A challenge for clinicians treating these patients is the necessity to address symptoms and etiologies outside of the usual urologic evaluation

PURPOSE Recent clinical trials on primary retroperitoneal lymph node dissection (RPLND) for testicular seminoma highlight inaccuracies in conventional imaging for lymph node staging. Limited data exist on the accuracy of positron emission tomography (PET) in patients with chemotherapy-naïve testicular seminoma. We evaluated the accuracy of 18F-fluorodeoxyglucose (FDG) PET for the detection of metastatic

PURPOSE The purpose of this study was to compare performance of Stockholm3 in an external validation with commonly used prostate cancer biomarkers and risk calculators. MATERIALS AND METHODS SEPTA was a multicenter trial validating Stockholm3 in a racially/ethnically diverse population of men meeting local care guidelines for prostate biopsy (2019-2023). In total, 2115 (98%) men with complete data

PURPOSE Urine calcium excretion (UCa) is greater after dinner and urine volumes are lower. The result is higher urine calcium concentrations, which may confer greater risk of stone formation, at night. We considered whether night-time administration-as compared with daytime administration-of thiazides would be more effective for stone prevention. MATERIALS AND METHODS We performed 12-hour urine collections

PURPOSE Literature supporting antimicrobial prophylaxis for hypospadias repairs is lacking, with largest studies including several hundred subjects. We sought to evaluate the association of a single dose of preoperative antibiotics in hypospadias repairs on postoperative outcomes using the National Surgical Quality Improvement Program-Pediatrics. MATERIALS AND METHODS The 2021 to 2022 National Surgical

PURPOSE Variability in the interpretation of videourodynamics studies limits reliable classification of kidney injury risk for patients with spina bifida. We developed machine learning models to predict incident hydronephrosis in patients with spina bifida using videourodynamics data. MATERIALS AND METHODS We trained machine learning models using data from videourodynamics studies performed between

PURPOSE The EAU guidelines and the latest recommendations from the US Prostate Cancer Conference suggest a castration threshold of 20 ng/dL. However, the current NCCN and AUA guidelines still recommend a castration standard of 50 ng/dL. It remains unknown whether there is a relationship between maintaining lower testosterone levels and the prognosis of patients with nonmetastatic castration-resistant

PURPOSE We tested feasibility of burst wave lithotripsy (BWL) and ultrasonic propulsion to noninvasively fragment and expel small, asymptomatic renal stones in awake participants. MATERIALS AND METHODS Adult patients suspected of having 2- to 7-mm stones were consented and screened for eligibility. BWL and ultrasonic propulsion were applied to up to 3 stones in 1 kidney of qualifying participants for

PURPOSE Childhood urinary incontinence (UI) is a common disorder with significant negative impact on self-esteem and quality of life, but the impact on school performance is unknown. This study investigates how UI in children is associated with school performance. MATERIALS AND METHODS This is a nationwide matched cohort study of children born in Denmark to Danish parents between 1997 and 2008 investigating

PURPOSE Prostate Imaging Reporting and Data System (PIRADS) v2.1 scoring with multiparametric (mp) MRI has a pooled 90% negative predictive value (NPV). PSA density (PSAD) ≤ 0.15 ng/mL/cm3 has been shown to enhance mpMRI's NPV in non-Black men. Populations with higher disease prevalence are known to have lower NPVs. Given that Black men have higher prostate cancer prevalence, we evaluate sensitivity

PURPOSE We assessed differences in complications and readmissions between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). MATERIALS AND METHODS This study uses data from the per-protocol population of the Randomized Robotic-Assisted vs Open Radical Cystectomy (RAZOR) study, a multicenter, open-label, phase 3, noninferiority clinical trial. RAZOR enrolled across 15 academic

PURPOSE Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments of small renal masses. While guidelines list thermal ablation as an option for tumors < 3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses > 3 cm. MATERIALS AND METHODS Patients treated with PN or CA for cT1/cT2, N0M0

PURPOSE Adults with low-grade intermediate-risk NMIBC commonly ask urologists how their routine/responsibilities will be affected by treatments, including the standard of care, transurethral resection of bladder tumor (TURBT). We asked patients in the ENVISION trial to compare TURBT with a nonsurgical primary treatment (UGN-102 containing mitomycin) for acceptability and impact on their routine/responsibilities

PURPOSE Lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) affects quality of life. Convective water vapor thermal therapy (CWVTT-Rezum) is a minimally invasive surgical treatment for LUTS/BPH which produces significant improvement of LUTS in men with prostates between 30 cc and 80 cc with minimal de novo sexual dysfunction. However, outcomes across the prostate volume (PV)

PURPOSE There are no standardized guidelines for evaluation of pediatric renal trauma. We hypothesize that screening radiographic studies performed to rule out traumatic renal injuries in children can initially be evaluated by contrast-enhanced CT scans that lack an excretory phase. MATERIALS AND METHODS We retrospectively collected data from 5 pediatric trauma centers between 2007 to 2020. Patients

PURPOSE In 2023 the AUA in collaboration with the Society for Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) requested an Update Literature Review to incorporate new evidence generated since the 2020 publication of this Guideline. The resulting 2025 Microhematuria Guideline Amendment addresses updated recommendations to provide a clinical framework for the diagnosis, evaluation

PURPOSE We investigated the efficacy and safety of tislelizumab as neoadjuvant therapy in patients with cisplatin-ineligible high-risk upper tract urothelial carcinoma (UTUC). MATERIALS AND METHODS In this single-arm phase 2 trial (NCT04672330), 20 patients with high-risk UTUC were enrolled. Eligibility criteria included high-risk UTUC (defined as high-grade UTUC confirmed by endoscopic biopsy or urinary

ISUP Grade-Group (GG) is based on the relative proportion of Gleason patterns 3 and 4. We investigated whether absolute pattern 4 volume is more strongly associated with advanced stage and biochemical recurrence than GG in patients with pattern 4 but not 5.

Several phase II trials have investigated the efficacy of retroperitoneal lymph node dissection (RPLND) with unilateral modified template as the first-line treatment for stage II seminoma. However, the rationale for using modified templates is extrapolated from studies of non-seminomatous germ cell tumor (NSGCT). In this retrospective study, we sought to compare the oncologic outcome of bilateral and

PURPOSE The addition of systematic prostate biopsy enhances the detection of clinically significant prostate cancer compared with MRI-targeted biopsy alone. However, there is growing interest in using only MRI-targeted biopsy. We sought to evaluate PSA density (PSAD) as an adjunctive predictor of clinically significant prostate cancer detection in men undergoing combined biopsy and as a potential metric

PURPOSE Patients with intermediate-risk (IR) nonmuscle-invasive bladder cancer (NMIBC) are recommended to receive induction intravesical chemotherapy or immunotherapy. However, the comparison between gemcitabine and bacillus Calmette-Guérin (BCG) in treatment-naïve patients with low-grade IR-NMIBC remains underexplored. The aim of this study was to evaluate the efficacy of gemcitabine compared with

PURPOSE Our goals were to assess the survival outcomes of adjuvant radiation therapy (aRT) vs observation with or without early salvage radiation therapy for cN0M0 pN1 prostate cancer (PCa) and to create a model for clinical decision-making. MATERIALS AND METHODS We retrospectively identified 1103 patients with cN0M0 PCa with pN1 PCa after surgery (2000-2021) at 18 referral centers. Kaplan-Meier curves

PURPOSE Pulse-modulated holmium:YAG (Ho:YAG) and SuperPulse thulium fiber laser are high-power laser systems used for retrograde intrarenal surgery. We conducted a prospective randomized trial to compare lithotripsy efficiency, complications, and stone-free rates. MATERIALS AND METHODS Patients with CT-confirmed intrarenal stones between 5 and 20 mm were randomly assigned to pulse-modulated Ho:YAG

PURPOSE Urinary incontinence (UI) is common in nulliparous female elite athletes, but underlying pathophysiology is inadequately understood. We examined urinary symptoms and associated pelvic floor anatomy and function in this population, hypothesizing that athletes with UI would exhibit pelvic floor findings seen in older incontinent women (eg, pelvic floor descent and urethral hypermobility) and

PURPOSE Conventional prostate magnetic resonance imaging has limited accuracy for clinically significant prostate cancer (csPCa). We performed diffusion basis spectrum imaging (DBSI) before biopsy and applied artificial intelligence models to these DBSI metrics to predict csPCa. MATERIALS AND METHODS Between February 2020 and March 2024, 241 patients underwent prostate MRI that included conventional

PURPOSE We aimed to determine whether implementation of a clinical decision support (CDS) tool integrated into the electronic health record of a multisite academic medical center increased the proportion of patients with AUA "high-risk" microscopic hematuria (MH) who receive guideline-concordant evaluations. MATERIALS AND METHODS We conducted a 2-arm cluster randomized quality improvement project in

PURPOSE Clinical variables alone have limited ability to determine which patients will have recurrence after radical prostatectomy (RP). We evaluated the ability of locked multimodal artificial intelligence (MMAI) algorithms trained on prostate biopsy specimens to predict prostate cancer-specific mortality (PCSM) and overall survival (OS) among patients undergoing RP with digitized RP specimens. MATERIALS

PURPOSE Ideal treatment of lichen sclerosus (LS)-induced penile urethral strictures (PUS) remains elusive. The objective of this study was to compare multi-institutional outcomes of single-stage urethroplasty (SSU) with oral mucosal graft, staged urethroplasty, and perineal urethrostomy (PU) for treatment of LS-induced PUS. MATERIALS AND METHODS Multi-institutional analysis was performed at 9 centers

PURPOSE Our goal was to determine whether surgical planning based on 3D models allows for better surgical outcomes than conventional surgical planning in (1) complications, (2) surgical time, and (3) hospital stay. MATERIALS AND METHODS This multicenter clinical trial (NCT03738488) included 66 patients diagnosed with renal cell carcinoma and venous thrombus extension who underwent nephrectomy with

PURPOSE The 18-gene MyProstateScore 2.0 (MPS2) test was previously validated for detection of grade group (GG) ≥ 2 prostate cancer using post-digital rectal examination (DRE) urine. To improve ease of testing, we validated MPS2 using first-catch, non-DRE urine. MATERIALS AND METHODS Patients provided first-catch urine before biopsy. MPS2 values were calculated using previously validated models differing

PURPOSE We characterize trends in vasectomy utilization, delivery, and failure in a large administrative database. MATERIALS AND METHODS We used the Merative MarketScan (2007-2021) Commercial Database to identify vasectomized men. Vasectomy failure (VF) was defined as documented pregnancy ≥ 6 months post procedure. Additional outcomes include the need for repeat vasectomy within 1 year and birth rates

PURPOSE Although the provision of a survivorship care plan (SCP) has been recommended after prostate cancer (PCa) treatment, there have been no randomized controlled trials to examine their impact. The objective of this study was to evaluate the effect of a tailored PCa-SCP intervention provided to early-stage PCa survivors. MATERIALS AND METHODS A prospective, parallel 1:1 randomized controlled trial

PURPOSE We assessed efficacy and safety of URO-902, an investigational gene therapy expressing the α subunit of the large-conductance Ca2+-activated K+ channel, in a phase 2a placebo-controlled trial in women with overactive bladder (OAB). MATERIALS AND METHODS Women, age 40 to 79 years, with OAB and urge urinary incontinence who were refractory to OAB medications were randomized to single-dose URO-902

PURPOSE Balancing surgical margins and functional outcomes is crucial during radical prostatectomy for prostate cancer. Stimulated Raman histology (SRH) is a novel, real-time imaging technique that provides histologic images of fresh, unprocessed, and unstained tissue within minutes, which can be interpreted by either humans or artificial intelligence. MATERIALS AND METHODS Twenty-two participants

PURPOSE Patients with refractory neurogenic bladder dysfunction may require urinary reconstruction due to severe incontinence, difficulty with catheterization, and to prevent upper urinary tract compromise. We evaluated long-term decisional regret and associated factors after urinary reconstruction in patients with spinal cord injury. MATERIALS AND METHODS We interviewed patients with spinal cord injuries

PURPOSE Ureteral stents are commonly placed intraoperatively during radical cystectomy, although their efficacy in reducing complications is unproven. We compared clinical outcomes among patients undergoing robot-assisted radical cystectomy with intracorporeal ileal conduit (RARC-IC) with or without ureteral stents to determine if omission of ureteral stents affects postoperative complications. MATERIALS

PURPOSE Endoscopic management (EM) is an increasingly accepted option for upper tract urothelial carcinoma (UTUC). Feasibility can be dependent on a variety of variables. The objective of this study was to identify anatomic and phenotypic tumor characteristics that affect EM, using structured expert forecasting, develop and obtain consensus on an assessment score, and perform initial validation of

PURPOSE Genitourinary rhabdomyosarcoma (GU-RMS) often requires multimodal therapy treatment including radiation, chemotherapy, and radical surgery for disease control. The long-term effects of the disease and associated treatments are unclear. We sought to investigate the long-term genitourinary quality of life for adult survivors of pediatric GU-RMS. MATERIALS AND METHODS In total, 14 participants