Open Access

REVIEW

Hang Gu¹, Yihan Shi¹, Xiancheng Du¹, Bo Zhang¹, Chunhui Liu¹, Ming Chen^1,*, Yuanji Shen^2,*, Chao Sun^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.085214
（This article belongs to the Special Issue: Andrology and Sexual Medicine in the Modern Era: Challenges and Breakthroughs)
Abstract Erectile dysfunction (ED) is a multifactorial disorder closely associated with vascular dysfunction, metabolic disease, impaired smooth muscle regulation, and aging-related changes. Although phosphodiesterase type 5 inhibitors (PDE5i) remain the cornerstone of pharmacological treatment, a substantial proportion of patients, particularly those with diabetes, endothelial dysfunction, or complex cardiometabolic comorbidities, show incomplete or inadequate responses. These limitations have encouraged growing interest in alternative pathways that regulate cavernosal smooth muscle tone beyond the classical nitric oxide–cyclic guanosine monophosphate axis. Mirabegron, a selective β₃-adrenergic receptor agonist widely used for overactive bladder, has recently attracted attention as a potential repurposing candidate… More >

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ARTICLE

Caixiang Zhang^1,2,#, Xiaochuan Wang^1,2,#, Youquan Zhao^1,2, Houyu Zhou³, Kahriman Islam^4,5, Jesur Batur^4,5, Jun Li^1,2,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.083925
Abstract Objective: Bilateral kidney stones in preschool children are challenging to manage, and the optimal surgical strategy remains unclear. This study aimed to compare the efficacy and safety of bilateral single-session percutaneous nephrolithotomy (PCNL) and bilateral staged PCNL in preschool children with bilateral kidney stones. Methods: We retrospectively reviewed preschool children aged <7 years with bilateral kidney stones who underwent PCNL at our two centers between June 2014 and June 2025. Patients were divided into a bilateral staged PCNL group and a bilateral single-session PCNL group. Perioperative outcomes, stone-free rate (SFR), and complication rate (CR) were… More >

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HOW I DO IT

Kathryn Fink, Jonathan Rosenfeld, Shivani Kumaresan, Olivia Ben-Levy, Anna Lytchakov, Shania Wang, Diboro Kanabolo, Ziho Lee^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.084280
Abstract The Indiana pouch is a continent catheterizable urinary diversion that can provide durable continence. Although rare, persistent leakage from the catheterizable channel is a difficult complication to manage. We describe our technique for robotic fundoplication of the Indiana pouch in a patient with refractory stoma incontinence despite preserved pouch compliance and capacity. A 37-year-old woman with neurogenic bladder had continuous leakage from her catheterizable channel for nine years after cystectomy and Indiana pouch creation. Preoperative evaluation showed a compliant 600 cc reservoir without elevated storage pressures, suggesting failure of the channel continence mechanism rather than More >

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ARTICLE

Yifan Huang^1,2,#, Bingzhi Han^2,#, Xin Lian^1,3,#, Qianhao Huang², Zikai Huang^1,2, Yushan Huang^4,*, Bin Chen^1,2,*, Yuedong Chen^1,2,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.081319
（This article belongs to the Special Issue: Advancing the Diagnosis and Treatment of Urological Diseases through Big Data)
Abstract Backgrounds: Benign prostatic hyperplasia (BPH) is a common chronic condition in older men, imposing substantial global healthcare burden. This study aims to assess the global, regional, and age-specific burden of BPH among adults aged 50–79 years from 1990 to 2021 using GBD 2021 data, and to forecast trends through 2036.
Methods: Prevalence, Incidence and Disability-Adjusted Life Years (DALYs) were assessed by age and Socio-demographic Index (SDI); decomposition analysis and Bayesian Age-Period-Cohort modeling were applied.
Results: In 2021, there were approximately 112.5 million global prevalent BPH cases (ASPR: 2782.6 /100,000) and 2.23 million DALYs (ASDR: 55.1/100,000). Middle-SDI regions bore the More >

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ARTICLE

Naoki Wada^*, Taichiro Ishimaru, Tsubasa Hatakeyama, Hajime Ishida, Riku Takada, Kotona Miyauchi, Noriyuki Abe, Daiki Kikuchi, Miyu Ohtani, Shin Kobayashi, Kazuyuki Numakura
Canadian Journal of Urology, DOI:10.32604/cju.2026.081742
Abstract Backgrounds: Metabolic acidosis (MA) is a known metabolic complication after urinary diversion using intestinal segments, but its occurrence after ileal conduit (IC) has been less well characterized than after orthotopic neobladder. This study aimed to investigate the occurrence of subacute MA following radical cystectomy (RC) and IC in the era of robotic surgery. Methods: Data of patients who underwent RC and IC from January 2014 onward were collected retrospectively. MA was defined as a pH of <7.35 and an HCO₃ level of <22 mEq/L. In addition, the risk factors for developing subacute postoperative MA, including robotic… More >

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ARTICLE

Dingran Li^1,2,#, Jingcheng Lyu^1,2,#, Yichen Zhu^1,2,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.084467
Abstract Objective: Although iliac artery calcification has been recognized as an important prognostic factor affecting renal transplant outcomes, its quantitative integration into a practical predictive model for Delayed Graft Function (DGF) remains lacking. This study therefore aimed to identify independent risk factors for DGF and develop a composite predictive model based on iliac artery calcification. Methods: This retrospective study included 257 patients who underwent living donor renal transplantation from January 2017 to October 2025. Clinical data, including conventional risk factors, and pre-operative CT measurements of iliac artery calcification score (Agatston score) and plaque-to-anastomosis distance, were collected.… More >

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ARTICLE

Guowei Du^1,#, Jianhuai Chen^2,#, Heng Wang³, Shanshan Chen¹, Yanting Wang¹, Jing Wang¹, Guangzhao Yang⁴, Siwen Liu^5,*, Xuanyi Chen^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.079068
（This article belongs to the Special Issue: Integrating Andrology into Reproductive Medicine: Challenges and Innovations in Male Infertility)
Abstract Background: Elevated body mass index (BMI) often involves metabolic disturbances, which may influence sperm quality and intrauterine insemination (IUI) pregnancy success. Understanding the metabolic factors’ mediating role here is essential to clarify how elevated male BMI links to reproductive outcomes. Methods: This retrospective study included 220 couples undergoing IUI at Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine (July 2022 to December 2024). Male partners were stratified by BMI categories according to Chinese criteria. Baseline demographic, metabolic parameters (alanine aminotransferase [ALT], aspartate aminotransferase [AST], gamma-glutamyl transferase [GT], fasting plasma glucose [FPG], triglycerides [TG],… More >

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ARTICLE

Katherina Y. Chen^1,*, Max Stempel², Luis Gonzalez Miranda³, Aisha Kazeem⁴, Nicolas M. Ortiz,¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.075344
Abstract Background: Outside medical records (OMR), while necessary for tertiary referral care, often contain irrelevant or redundant information due to poor electronic medical record usability, which has been reported as a large contributor to physician burnout. This study aims to quantify and classify the superfluous portions of OMR received by urologists at an academic referral center. Methods: All initial adult visits seen by five urologists over a six-month period were reviewed by two independent reviewers. The number of pages of the OMR relevant to the consultation question was recorded. Superfluous content was classified as clinical-but-not-relevant/duplicate or… More >

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ARTICLE

Xinfeng Chen^#, Xiaoyi Li^#, Xin Xu, Suning Kang, Jie Jiang, Zhenmin Liu, Yong Zhang, Zhan Chen, Cheng Shen, Bing Zheng, Hua Zhu^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.080517
Abstract Objective: Uric acid stones and non-uric acid stones differ significantly in treatment strategies, yet accurately identifying stone composition preoperatively remains challenging, which directly affects individualized treatment planning. Therefore, this study investigates the clinical determinants of uric acid stone formation to construct a predictive model for clinical application. Methods: The demographic and clinical data of 229 individuals with urinary calculi were retrospectively analyzed. Participants were classified into two groups according to stone composition: a non-uric acid stone group (n = 135) and a uric acid stone group (n = 94). The general information, blood and urine… More >

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ARTICLE

Haiwen Zhou^#, Yan Zhao,^#, Jingxian Li^#, Yuanjiong Qi, Yang Liu, Changwen Zhang, Yue Chen^*, Shiyong Qi^*, Zhihong Zhang^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.081481
（This article belongs to the Special Issue: Advances in Diagnosis and Management of Bladder Cancer: From Molecular Insights to Therapeutic Innovations)
Abstract Background: Regulated cell death (RCD) is critical for tumor progression and treatment response, but its integrated role in bladder cancer remains unclear. This study aimed to systematically characterize the cross-talk, multi-omics alterations, and clinical relevance of major RCD pathways in bladder cancer. Methods: Publicly available bladder cancer cohorts were analyzed to characterize the expression patterns and integrated regulation of major regulated cell death (RCD) programs. A curated set of 862 RCD-related genes was compiled from public databases and published literature, encompassing apoptosis, ferroptosis, pyroptosis, necroptosis, and autophagy-dependent cell death. Patients were stratified according to RCD-related… More >

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REVIEW

Salvatore Siracusano^1,*, Igino Andrea Magli¹, Andrea Pedreschi¹, Antonio Benito Porcaro², Gianluca Baldini³, Cristina Lonardi⁴
Canadian Journal of Urology, DOI:10.32604/cju.2026.076061
（This article belongs to the Special Issue: Evaluation of the Quality of Life in Cystectomized Patient: How, When and Why?)
Abstract This review aims to summarize recent evidence on quality of life (QoL), functional, and oncologic outcomes in women undergoing radical cystectomy (RC). In this way, a comprehensive literature review was conducted, analyzing studies published on female patients undergoing RC with ileal conduit (IC) or orthotopic neobladder (ONB) urinary diversion. Emphasis was placed on the use of validated patient-reported outcome measures (PROMs), including EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), QLQ-BLM30 (Quality of Life Questionnaire-Muscle-Invasive Bladder Cancer Module 30), FACT-VCI (Functional Assessment of Cancer Therapy-Vanderbilt Cystectomy Index),… More >

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HOW I DO IT

Camila Pedergnana^*, Lucas Bergadá, Federico Ignacio Tirapegui, Guillermo Montelli Yanzi, Diego Santillan, Christian Cristallo, Mariano Sebastian Gonzalez
Canadian Journal of Urology, DOI:10.32604/cju.2026.084567
（This article belongs to the Special Issue: Prostatic Enucleation: Current Evidence and Contemporary Practice)
Abstract Urethral stricture continues to challenge boundaries of minimally invasive laser enucleation of the prostate (MiLEP) particularly when low-caliber systems preclude conventional transurethral morcellation when using an Ultra Slim 18.5 Fr mini resectoscope. We describe a simple yet effective technical adaptation using suprapubic morcellation that may overcome this limitation and expand the indications for a fully endoscopic approach in patients who would otherwise not be considered candidates offering a reproducible and low-morbidity solution. The objective of this article is to describe a surgical alternative for endoscopic prostatic adenoma morcellation. More >

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REVIEW

Qiancheng Shi^1,2,#, Siqi Li^3,#, Yanan Qian^4,#, Shengqian Wang^4,*, Nan Lu^1,5,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.084056
（This article belongs to the Special Issue: Evidence-Based Urology: Bridging Clinical Controversies and Contemporary Practice)
Abstract With the rising incidence of early-onset prostate cancer and improved long-term survival rates, fertility preservation has become an increasingly important yet often overlooked aspect of survivorship care for men diagnosed with this disease. Despite growing recognition of this issue, clinical practice continues to lack standardized approaches to fertility assessment and preservation both prior to and following treatment. This review synthesizes current evidence regarding the mechanisms underlying treatment-induced infertility and evaluates available clinical strategies for fertility preservation in this patient population. Radical prostatectomy disrupts ejaculatory function primarily through loss of seminal vesicle contractility and disruption of… More >

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REVIEW

Xiejunhao Zheng^1,2,#, Zitong Wang^1,2,#, Tiange Wu^1,2,#, Chunhui Liu¹, Ming Chen^1,*, Chao Sun^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.083360
Abstract Objectives: Reactive oxygen species (ROS) are key contributors to male infertility, yet conventional assessments often evaluate oxidative stress in isolation without considering the reductive counterpart. Normalized oxidation-reduction potential (nORP), commonly measured using the MiOXSYS system, has been proposed as a marker of seminal redox status. This systematic review and meta-analysis aimed to evaluate the associations between nORP and conventional semen parameters and sperm DNA fragmentation (SDF). Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects models were used to pool correlation coefficients between… More >

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REVIEW

Indiamara Deggerone^1,*, Tamy Colonetti², Luciane Bisognin Ceretta², Maria Inês da Rosa², Antônio José Grande
Canadian Journal of Urology, DOI:10.32604/cju.2026.081322
Abstract Background: Sexual dysfunction is an underrecognized dimension of functional impairment in men with fibromyalgia, a chronic pain condition associated with substantial multisystem burden. This study aimed to systematically review and narratively synthesize the available evidence on sexual dysfunction in men with fibromyalgia, positioning sexual health as a clinically relevant functional outcome. Methods: A systematic search of MEDLINE/PubMed, Scopus, EMBASE, Web of Science, and the Cochrane Library (January 1990–December 2025) was conducted to identify observational studies assessing sexual function in adult men diagnosed with fibromyalgia. Due to marked clinical and methodological heterogeneity, including variability in diagnostic… More >

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REVIEW

Emmanouil Panagiotidis¹, Filippos Koinis², George Angelidis^1,*, Varvara Valotassiou¹, Ioannis Tsougos³, Athanasios Kotsakis², Panagiotis Georgoulias¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.081194
（This article belongs to the Special Issue: Advanced Multimodal Imaging for Localized Prostate Cancer and Biochemical Recurrence of Prostate Cancer)
Abstract Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has emerged as a transformative imaging modality in the management of prostate cancer, particularly for patients with localized disease and those experiencing biochemical recurrence (BCR). This review focuses on the clinical applications of PSMA PET imaging in these two critical clinical scenarios, where accurate disease detection and localization directly impact treatment decisions. For patients with localized high-risk prostate cancer, PSMA PET provides superior staging accuracy compared to conventional imaging, detecting occult lymph node and distant metastases that may change the therapeutic approach from curative local treatment to… More >

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REVIEW

Salvador Jaime-Casas¹, Roberta Corvino², Jan Łaszkiewicz³, Amir Khan⁴, Benjamin I. Chung⁵, Vincenzo Asero², Valerio Santarelli², Dalila Carino², Sarah Carvalho Ribeiro², Stefano Impaloni², Francesco Del Giudice^2,5,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.080402
Abstract Background: Artificial intelligence (AI)-based models are increasingly being explored for the diagnostic evaluation of patients undergoing assessment for bladder cancer (BC). The aim of this study was to systematically review the literature regarding the use of AI models for tumor detection during bladder endoscopy in patients with suspected BC, providing a comprehensive qualitative synthesis of their diagnostic performance. Methods: We systematically searched PubMed, Embase, and Scopus databases from inception to 30 September 2025 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies reported the diagnostic performance of AI-based technologies… More >

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ARTICLE

Mitchell Hoestermann^*, Regan Merkin, Scott O. Quarrier, Ashley Li, Yadong Lu, Rajat Kumar Jain, Jean Joseph, Thomas Osinski
Canadian Journal of Urology, DOI:10.32604/cju.2026.078662
（This article belongs to the Special Issue: Prostatic Enucleation: Current Evidence and Contemporary Practice)
Abstract Background: Laser enucleation of the prostate (LEP) remains underutilized despite strong guideline support, partly because of its steep learning curve and limited access to realistic simulation tools. We developed a hydrogel model incorporating a penis, prostate, distensible bladder, and pelvis, and conducted a pilot feasibility study to evaluate usability and face validity during a hands-on workshop. Methods: This prospective, single-session pilot study was conducted during the 2024 Northeastern Section of the American Urological Association (NSAUA) meeting. Nine LEP novices (two attendings, one fellow, six residents) each performed enucleation of a 75 g hydrogel prostate using… More >

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CASE REPORT

Matthew Kwon^1,2,*, Dominic Bagguley¹, Dane Cole-Clark¹, Albert Tiu¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.083068
Abstract Background: Bladder leiomyomas are rare benign tumours arising from smooth muscle cells, accounting for less than 0.5% of all bladder neoplasms. Surgical excision remains the gold standard for management; however, few reports describe the use of robotic assistance for this purpose. Case Description: We present the case of a woman in her mid-30s who developed painless macroscopic haematuria and acute urinary retention, with imaging revealing a large bladder leiomyoma. Following unsuccessful endoscopic management and hysterectomy, she underwent robotic-assisted transvesical excision of the lesion, resulting in marked symptomatic improvement. Conclusions: Larger bladder leiomyomas can present significant diagnostic More >

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HOW I DO IT

Andres Benitez-Filselcker¹, Felipe Aguila^1,2, Cristobal Avila¹, Tomas Punte^1,3, Jaime Barahona⁴, Fernando Marchant^1,2,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.080162
（This article belongs to the Special Issue: Advances in Endoscopic Management of Urolithiasis)
Abstract Overview: Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large and complex renal stones. Although it offers high stone-free rates, it remains associated with a significant risk of complications, particularly infectious events. Intrarenal pressure (IRP) has emerged as an important yet underrecognized determinant of safety during PCNL. Objectives: This article aims to describe a practical technique for real-time IRP monitoring during various PCNL procedures using a retrograde, open-ended ureteral catheter connected to a fluid-filled pressure transduction system and standard anesthesia monitoring equipment. We also report our initial clinical experience with IRP monitoring during standard More >

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ARTICLE

Hao Wang^1,#, Yijie Xie^1,#, Meixuan Ding^2,#, He Gong³, Qi Zheng³, Jiaxin Zheng³, Bo Duan³, Tao Wang^3,*, Peide Bai^3,*, Bin Chen^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.082776
（This article belongs to the Special Issue: Advances in Endoscopic Management of Urolithiasis)
Abstract Objective: Although retrograde intrarenal surgery is a common approach for kidney stones, successfully eliminating 1–3 cm calculi is often hindered by inadequate aspiration and the dangers of elevated intrarenal pressure. This research evaluated the clinical effectiveness and safety profile of utilizing a flexible and navigable suction ureteral access sheath (FANS) versus a traditional ureteral access sheath (T-UAS) for managing 1–3 cm renal calculi during flexible ureteroscopy. Methods: We conducted a retrospective review of 338 individuals treated for 1–3 cm kidney stones from May 2024 to November 2025. Participants were categorized into either a FANS cohort (n… More >

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ARTICLE

Qi Wang^1,2,3,4,5, Jiayan Xin^3,4,5,6, Minghao Zhang^2,3,4,5, Yong Wang^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.080510
（This article belongs to the Special Issue: Advancing Early Detection of Prostate Cancer: Innovations, Challenges, and Future Directions)
Abstract Backgrounds: Early detection of prostate cancer (PCa) in patients with acute urinary retention (AUR) is complicated by transient, non-malignant elevations of prostate-specific antigen (PSA). Density-based biomarkers such as PSAD and fPSAD may help overcome this limitation. This study aims to assess the diagnostic significance of prostate-specific antigen density (PSAD) and free prostate-specific antigen density (fPSAD) in the early diagnosis of prostate cancer (PCa) among patients with acute urinary retention (AUR). Methods: The clinical data of 1343 patients with AUR were retrospectively analyzed. The differences in the indexes between the PCa group and the benign prostatic… More >

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MINI REVIEW

Mallory Pine¹, Marium Ansari¹, Alise Hale¹, Ramzy Burns^2,*, Helen L. Bernie²
Canadian Journal of Urology, DOI:10.32604/cju.2026.078958
（This article belongs to the Special Issue: Advances in Men's Health: The Latest in Andrology, Male Infertility, and Sexual Medicine)
Abstract Introduction: Male sexual dysfunction (MSD) is a prevalent condition traditionally evaluated and treated through a male-centric lens, despite growing recognition that sexual health is inherently relational. Emerging evidence demonstrates that female sexual dysfunction (FSD) plays a critical role in shaping male sexual outcomes, treatment satisfaction, and overall relationship well-being. FSD is common, multifactorial, and influenced by biological, psychological, and relational factors, with prevalence estimates varying depending on the presence of associated distress. Similarly, MSD encompasses a broad spectrum beyond erectile dysfunction, including ejaculatory disorders, hypogonadism, and penile deformity, many of which remain underrecognized. Across multiple studies,… More >

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CASE REPORT

Ruiyang Hu¹, Nianben Chen², Jingxing Wu², Wenjun Ma³, Youjin Cai³, Qinglin Hu^3,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.078839
Abstract Backgrounds: Management of large mid-ureteral stones remains challenging due to anatomical constraints and the limitations of traditional techniques. Recent advances in flexible ureteroscopy and vacuum-assisted access sheaths offer new strategies for safe and effective stone removal. Case Description: We report the case of a 60-year-old male who presented with right-sided colicky flank pain. Non-contrast computed tomography revealed a 62 × 14 mm high-density stone located in the right mid-ureter, with associated hydronephrosis. Laboratory tests were largely unremarkable. The patient underwent successful holmium:YAG laser lithotripsy using a disposable digital flexible ureteroscope inserted through a deflectable vacuum-assisted ureteral More >

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ARTICLE

Antonio Benito Porcaro¹, Maria Angela Cerruto^1,*, Alberto Bianchi¹, Francesco Artoni¹, Francesca Montanaro¹, Alberto Baielli¹, Filippo Caudana¹, Andrea Franceschini¹, Alessandro Veccia¹, Riccardo Rizzetto¹, Matteo Brunelli², Riccardo Giuseppe Bertolo¹, Alessandro Antonelli¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.081303
（This article belongs to the Special Issue: Prostate Cancer: Biomarkers, Diagnosis and Treatment)
Abstract Background: Current prognostic stratification of prostate cancer (PCa) does not fully capture disease heterogeneity. Common biopsy-based parameters, such as the percentage of biopsy positive cores (BPC), do not account for prostate volume (PV). This study aims to evaluate the association between the index density of biopsy positive cores (Id-BPC), defined as the ratio of BPC to prostate volume, and disease progression after robot-assisted radical prostatectomy (RARP). Materials and Methods: We retrospectively analyzed 1047 consecutive PCa patients treated with RARP between January 2013 and December 2021. Inclusion criteria were: ≥12 systematic biopsy cores, available PV measurement, and… More >

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ARTICLE

Justine Grangeret^1,*, Olivier Schaeffer¹, Paul Jonard¹, Joel Aerts², Philippe P. Leveque², Philippe Barthelme², Christopher Bonnier¹, Octavian Dragusin³, Christian Picard¹, Jules Zhang-Yin¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.080433
（This article belongs to the Special Issue: Advanced Multimodal Imaging for Localized Prostate Cancer and Biochemical Recurrence of Prostate Cancer)
Abstract Backgrounds: Prostate-specific membrane antigen (PSMA) Positron Emission Tomography–Computed Tomography (PET/CT) is increasingly used for initial staging and biochemical recurrence (BCR) assessment in prostate cancer. The aim of this study was to describe PSMA PET/CT detection rates and disease patterns at a national tertiary referral center across initial staging and BCR. Methods: We retrospectively reviewed consecutive Gallium-68 Prostate-Specific Membrane Antigen-11 (68Ga-PSMA-11) PET/CT examinations performed between July 2021 and July 2025. The institutional database contained 554 examinations; 246 repeated examinations were excluded, leaving 308 first clinically relevant examinations. We then excluded 120 non-eligible indications (57 therapeutic assessments… More >

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REVIEW

Giulia Almiron da R. Soares^*, Saveliy Kelebeyev, Fernando Loyola-Nieto, Marcelo Mass Lindenbaum, Raevti Bole, Petar Bajic
Canadian Journal of Urology, DOI:10.32604/cju.2026.080759
（This article belongs to the Special Issue: Advances in Men's Health: The Latest in Andrology, Male Infertility, and Sexual Medicine)
Abstract Backgrounds: Peyronie’s disease (PD) leads to penile curvature, deformity, and shortening, which can significantly impair sexual function and quality of life. Conventional surgical approaches may correct curvature at the expense of penile length or erectile function. Multiple-incision-based, tunica-preserving non-grafting (TPNG) techniques, including the auxetic technique, tunical expansion procedure (TEP), and deep grid incision technique (DGIT), have recently emerged as reconstructive strategies that promote controlled mechanical expansion of the tunica albuginea. This systematic scoping review aimed to evaluate recent incision-based TPNG techniques for PD, focusing on their biomechanical rationale, technical features, reported clinical outcomes, safety profile,… More >

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ARTICLE

Guowei Du^1,#, Jianhuai Chen^2,#, Heng Wang³, Shanshan Chen¹, Yanting Wang¹, Jing Wang¹, Guangzhao Yang⁴, Siwen Liu^5,*, Xuanyi Chen^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.079848
（This article belongs to the Special Issue: Health Determinants of Male Fertility)
Abstract Objective: Given that the interactive effects of age and abstinence duration on semen quality remain unclear and current guidelines lack age-specific recommendations, this study aimed to evaluate the independent and interactive effects of these factors on semen parameters and to identify the optimal abstinence period for semen analysis across different age groups. Methods: A retrospective analysis was conducted on 1480 men who underwent semen analysis according to the WHO 5th edition guidelines. Participants were stratified by age (20–34 vs. 35–58 years) and abstinence duration (1–3, 4–6, and 7–11 days). A comprehensive set of semen parameters… More >

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REVIEW

Elijah Vanderkamp^1,#, Jacob M. Parker^1,#, Mark R. Wakefield^2,3, Yujiang Fang^1,2,3,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.078273
（This article belongs to the Special Issue: Prostate Cancer: Biomarkers, Diagnosis and Treatment)
Abstract Prostate cancer (PC) remains a global health challenge with metastatic progression driving PC-related mortality. Understanding the transition from localized disease to advanced disease allows novel therapeutics to be developed against metastatic disease. This is a comprehensive review that synthesizes the pathogenesis of advanced prostate cancer, evaluates key clinical trials in establishing current standards of care, and discusses promising novel therapeutics. This review examines phase III clinical data and phase I/II clinical trials for novel therapeutics. Research was obtained from PubMed, ASCO, and ESMO. All other evidence presented is from peer-reviewed journals obtained from PubMed. PC… More >

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ARTICLE

Mirjam Naomi Mohr, Arian Farid-Meck, Philipp Henniges, Lutz Trojan, Mathias Reichert^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.077550
Abstract Objectives: The risk of biochemical recurrence (BCR) following nerve-sparing (NS) prostatectomy remains controversial, and the natural progression of high-risk prostate carcinoma (PCa) appears to be less favorable than that of low- and intermediate-risk PCa. This study demonstrates that the oncological outcome in high-risk PCa is comparable to that in intermediate- and low-risk PCa after NeuroSAFE-guided NS prostatectomy, due to complete secondary resection (SR) of the neurovascular bundle (NVB) on the affected side. Methods: BCR, as well as associated risk factors, were evaluated 12 months after radical robot-assisted laparoscopic prostatectomy (RALP) performed as curative treatment for… More >

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ARTICLE

Ryuta Tanimoto^1,*, Shota Inoue¹, Yuho Sano¹, Satoko Kamada¹, Kenji Sugino¹, Katsumi Sasaki¹, Kasumi Yoshinaga², Yuki Maruyama², Yusuke Tominaga², Satoshi Katayama², Shingo Nishimura², Kensuke Bekku², Takuya Sadahira², Takehiro Iwata², Kohei Edamura², Tomoko Kobayashi², Yasuyuki Kobayashi², Motoo Araki²
Canadian Journal of Urology, DOI:10.32604/cju.2026.079886
Abstract Objectives: Supraumbilical (SU) camera ports are typically used during robot-assisted laparoscopic prostatectomy; however, transumbilical (TU) incisions may offer potential cosmetic advantages. This study aimed to compare patient-reported outcomes, including cosmetic outcomes, postoperative pain, and quality of life, between these two approaches. Methods: Between January 2019 and February 2022, 98 patients with localized prostate cancer were randomized to either a SU (n = 50) or TU (n = 48) camera port group, stratified by prostate volume, Gleason score, and age. Body image and cosmetic scale scores, postoperative pain, and health-related quality of life outcomes were prospectively… More >

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ARTICLE

Elisa Berdondini¹, Ahmed Eissa², Mauro Silvani¹, Andrea Margara¹, Mauro Gacci³, Salvatore Voce⁴, Giulio Reale⁴, Juan Ignacio Martinez-Salamanca⁵, Giuseppe Maiolino^5,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.074216
Abstract Introductions: Female lower urinary tract symptoms (LUTS) are heterogeneous and often reflect bladder outlet obstruction (BOO) from anatomic urethral disease. Evidence guiding surgery remains fragmented. This study aimed to evaluate surgical and patient-reported outcomes after reconstructive surgery for female anatomical urethral disease. Materials and Methods: We retrospectively analyzed a prospectively maintained, single-surgeon database of women undergoing urethral surgery (January 2017–April 2024) for female urethral stricture (FUS), female urethral diverticulum (FUD), or periurethral masses. Standardized preoperative assessment was applied; procedures included dorsal inlay buccal mucosa graft (DMG), ventral onlay grafts (VOG, buccal or vaginal), partial diverticulectomy, and… More >

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ARTICLE

Jinglai Lin^1,2,3,#, Dengqiang Lin^1,2,3,#, Zhun Wu⁴, Chao Huang⁴, Jinchun Xing^4,*, Bin Chen^4,*, Jiaxin Zheng^4,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.081735
Abstract Objectives: Calcium-containing stones account for the majority of urinary calculi, and genetic variation in calcium-signaling pathways may influence disease susceptibility. This study aims to determine whether common variants in STIM1, ORAI1, and TRPC1 are associated with susceptibility to calcium urolithiasis and to assess their clinical relevance. Methods: This single-center retrospective case-control study included 326 patients with calcium-containing urolithiasis and 198 controls. Thirteen tagSNPs in STIM1, ORAI1, and TRPC1 were genotyped using the Sequenom MassARRAY platform. Hardy–Weinberg equilibrium, allele- and genotype-based association analyses, logistic regression, exploratory genetic model analyses, linkage disequilibrium, haplotype analyses, and genotype–phenotype analyses… More >

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ARTICLE

Antonio Ruffo¹, Fabio Esposito², Vincenzo Maria Altieri¹, Ester Illiano³, Lorenzo Spirito⁴, Valerio Santarelli⁵, Francesco Del Giudice^5,*, Felice Crocetto⁶, Biagio Barone⁷
Canadian Journal of Urology, DOI:10.32604/cju.2026.081080
（This article belongs to the Special Issue: Prostatic Enucleation: Current Evidence and Contemporary Practice)
Abstract Objectives: Transperineal Laser Ablation (TPLA) has emerged as a minimally invasive/ejaculation-sparing alternative to traditional benign prostatic hyperplasia (BPH) surgical treatments. Aim of this study was to evaluate the mid-term outcomes of TPLA in treating patients with high-volume BPH. Methods: This prospective study included 66 patients with large-volume BPH (median volume 95 mL, IQR 78–120). A significant proportion presented with previous acute urinary retention (48.5%), with 28.8% being catheter-dependent preoperatively. All TPLA procedures were performed under local anesthesia. Efficacy was assessed by changes in the International Prostate Symptom Score (IPSS), quality of life index (IQoL), maximum… More >

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ARTICLE

Kemal Ertaş^1,*, Ali Yasin Özercan²
Canadian Journal of Urology, DOI:10.32604/cju.2026.070210
（This article belongs to the Special Issue: Urolithiasis in Focus: Integrated Perspectives on Infection, Metabolic Dysfunction, and Contemporary Management)
Abstract Objective: Retrograde intrarenal surgery (RIRS) is a widely adopted minimally invasive procedure for renal stones, yet accurately predicting its success remains challenging. This study aimed to evaluate the predictive value of three-dimensional (3D) stone volume compared with traditional maximal stone diameter for RIRS success and complications. Methods: This prospective single-center study included 122 patients undergoing RIRS for renal calculi. Preoperative non-contrast CT scans were used to measure stone volume using the ellipsoid formula. Surgical outcomes included stone-free rate (SFR; residual fragments ≤2 mm) and complications (Clavien-Dindo classification). Receiver operating characteristic (ROC) curves, DeLong’s test, and… More >

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ARTICLE

Andrea Rubinacci¹, Luigi De Luca², Ugo Amicuzi³, Pasquale Reccia⁴, Luigi Napolitano³, Simone Tammaro¹, Marco Stizzo¹, Dario Del Biondo⁵, Marco De Sio¹, Ciro Imbimbo³, Felice Crocetto³, Celeste Manfredi^1,*, Biagio Barone⁵
Canadian Journal of Urology, DOI:10.32604/cju.2026.083533
Abstract Background: Despite its minimally invasive profile for patients, retrograde intrarenal surgery (RIRS) may impose a considerable physical burden on the operating surgeon. This study aimed to evaluate the ergonomic impact of RIRS by characterizing the distribution and severity of musculoskeletal discomfort. Methods: This observational study included 42 consecutive RIRS procedures performed between January and December 2023 at a high-volume endourology center. Surgeon-reported discomfort was collected immediately after each procedure using an adapted assessment form based on the Italian version of the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ-I). Discomfort severity was graded across 10 predefined anatomical regions… More >

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REVIEW

Etan Eigner^1,2, Nicola Fazaa^1,2, Ameer Nsair^1,2, Melissa Atallah^1,2, Gilad E. Amiel^1,2, Azik Hoffman^1,2, Kamil Malshy^3,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.079599
Abstract Bladder cancer predominantly affects older adults, and transurethral resection of bladder tumor (TURBT) remains the cornerstone of diagnosis and management for non–muscle-invasive disease. As the bladder cancer population ages, TURBT is increasingly performed in patients with frailty, multimorbidity, and limited physiologic reserve. Although often framed as a routine procedure, the cumulative clinical implications of TURBT in elderly patients are increasingly recognized. The objective of this narrative review is to critically evaluate the perioperative, functional, psychosocial, and economic consequences of TURBT in older adults, with particular emphasis on frailty as a determinant of outcomes and on… More >

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REVIEW

Nicholas W. Shely¹, Jacob M. Parker¹, Hayden J. Oyler¹, Alexander C. Lien¹, Bode T. Eisenmenger², Mark R. Wakefield^2,3, Yujiang Fang^1,2,3,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.078502
（This article belongs to the Special Issue: Advances and Challenges In Male Infertility: From Molecular Mechanisms to Clinical Applications)
Abstract Male infertility (MI) is a common condition traditionally viewed as a strictly reproductive issue; however, increasing evidence suggests that MI may reflect a broader health issue. Associations of MI and metabolic syndrome (MetS), as well as autoimmune diseases, have been observed. This review summarizes the current evidence linking MI with these conditions, detailing how chronic oxidative stress, systemic proinflammatory cytokines and blood-testis barrier disruption serve as drivers of reproductive decline. Specifically, MetS impairs male fertility through central hypothalamic-pituitary-gonadal (HPG) axis dysregulation, oxidative stress, insulin resistance, and testicular hyperthermia. Autoimmune diseases, including rheumatoid arthritis, psoriasis, and More >

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REVIEW

Mohamed Jalloh^1,#,*, Louise Makau-Barasa^2,#, Joana Ainuson-Quampah³, Ada Okechukwu⁴, Lamine Niang¹, Oseremen Aisuodionoe-Shadrach⁵, Serigne Gueye¹, Akin Adebiyi⁶, Ben Adusei⁷, Pedro Fernandez⁸, Abraham van Wyk⁸, Olufemi Ogunbiyi⁹, James E. Mensah¹⁰, Caroline Andrews¹¹, Ilir Agalliu¹², Thomas Rohan¹³, Ann Hsing¹⁴, Timothy R. Rebbeck¹¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.077318
（This article belongs to the Special Issue: Advancing Early Detection of Prostate Cancer: Innovations, Challenges, and Future Directions)
Abstract Backgrounds: Prostate cancer (PCa) in Sub-Saharan Africa (SSA) is characterized by late-stage diagnoses and high mortality. PCa screening is uncommon. This review presents current evidence on PCa screening practices across SSA to identify prevailing trends, methodological limitations, and opportunities for early detection. Methods: A systematic literature review identified seven studies conducted in SSA over the past three decades, focusing on PCa screening modalities, population characteristics, geographical distribution, and outcomes. Studies were identified from PubMed, Embase, Web of Science, African Index Medicus, and Global Health and uploaded into Covidence for screening, sorting and data extraction. The… More >

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CASE REPORT

Changhao Hou^1,2,#, Ruihang Zhang^1,2,#, Pengbo Luo³, Weidong Zhu^1,2, Lujie Song^1,2,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.073870
Abstract Background: Urethroperineal fistula (UPF) is a rare urological condition with significant heterogeneity and limited treatment consensus. Especially in patients with a history of radiotherapy, extensive tissue damage often leads to insufficient local tissue reconstruction. Case Description: A 61-year-old male with a history of rectal cancer radiotherapy and abdominoperineal resection developed UPF, which recurred after robot-assisted prostatectomy combined with perineal fistula repair and scrotal dartos flap interposition. Imaging confirmed a 2 cm × 3 cm fistula defect at the prostatic urethra stump. We performed gracilis muscle flap transfer to repair UPF. Postoperative follow-up included urethrography, cystoscopy, and More >

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CASE REPORT

Wenda Wang, Xingcheng Wu^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.081697
Abstract Backgrounds: Solitary fibrous tumor (SFT) is a rare mesenchymal tumor composed of spindle cells, accounting for less than 2% of all soft tissue tumors. It usually occurs in the visceral pleura but can also arise extrapleurally. However, SFT arising in the prostate is rare. Case Description: A 75-year-old male patient was found to have a space-occupying lesion measuring 4.1 × 3.8 cm located in the left peripheral zone at the base of the prostate. Total prostate-specific antigen (PSA) was 13.2 ng/mL. Prostate needle biopsy revealed histopathological features consistent with prostatic SFT. The patient had received subcutaneous… More >

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ARTICLE

Kemal Ertas^1,*, Veysel Tahiroglu², Hasan Karagecili³, Emrah Yerlikaya⁴, Revsa Evin Canpolat Erkan⁵, Erkam Coskun⁶
Canadian Journal of Urology, DOI:10.32604/cju.2026.079146
（This article belongs to the Special Issue: New Perspectives and Advances in Andrology and Andological Surgery)
Abstract Background: Premature ejaculation (PE), the most common male sexual dysfunction worldwide, has a pathophysiology that is not fully understood and lacks reliable biomarkers. Recent studies suggest a potential role for polyamine metabolism in neuroregulation and sexual function. This study investigated the association between serum spermidine synthase (SRM) levels and acquired PE. Methods: In this prospective cross-sectional study conducted at Sirnak State Hospital between March and August 2024, 82 men (43 patients with acquired PE and 39 age-matched controls) were evaluated. Intravaginal ejaculation latency time (IELT) was measured by stopwatch (patient and/or partner-assisted), metabolic parameters were… More >

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ARTICLE

Daniel M. Klyde^*, Tareq Aro, Zeph Okeke, David M. Hoenig, Zachary E. Tano, Arun Rai, Jared S. Winoker
Canadian Journal of Urology, DOI:10.32604/cju.2026.079115
Abstract Objectives: The landscape of ureteroscopic surgery is rapidly evolving with the emergence of suction-based technologies. We sought to evaluate the effectiveness, safety, and surgeon experience for steerable ureteroscopic renal evacuation (SURE) using the second-generation CVAC^® System. Methods: We reviewed all patients who underwent SURE with the CVAC 2.0 system after initial launch at a large, multicenter academic institution between February 2024 and February 2025. Postoperative adverse events within 30 days after treatment were reported. Stone burdens were measured by computed tomography (CT)-based stone volume and cumulative maximal stone diameter. Surgical effectiveness was evaluated by CT-based stone-free… More >

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REVIEW

Daniel Ajabshir^*, Adriana Pedraza, Ash Tewari
Canadian Journal of Urology, DOI:10.32604/cju.2026.079661
（This article belongs to the Special Issue: Advances in Microultrasound Imaging for Prostate Cancer)
Abstract Active surveillance (AS) requires reliable imaging to detect grade progression in low-risk prostate cancer. This narrative review evaluates the role of high-resolution micro-ultrasound (micro-US) in AS and its integration with multiparametric magnetic resonance imaging (mpMRI). A targeted synthesis of randomized trials, prospective cohorts, and meta-analyses through December 2025 was performed. The OPTIMUM randomized trial demonstrated non-inferiority of micro-US–guided biopsy for detecting Grade Group 2 or higher cancer. In AS cohorts, micro-US shows high sensitivity (94–97%) and negative predictive value (88–97%) for detecting grade reclassification. These findings support its role as a real-time targeting modality and More >

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REVIEW

Yuka Sugizaki, Takanobu Utsumi^*, Rino Ikeda, Naoki Ishitsuka, Yuta Suzuki, Takahide Noro, Shota Iijima, Takatoshi Somoto, Ryo Oka, Takumi Endo, Naoto Kamiya, Hiroyoshi Suzuki
Canadian Journal of Urology, DOI:10.32604/cju.2026.081579
（This article belongs to the Special Issue: Advances in Endoscopic Management of Urolithiasis)
Abstract Sepsis remains the most serious infectious complication across the endoscopic stone surgery pathway, spanning the spectrum from infected obstructive presentation to the perioperative course of ureteroscopy. This structured narrative review synthesizes clinically actionable evidence across four recurrent decision points: initial presentation, pre-ureteroscopy optimization, intraoperative management, and early postoperative surveillance. The most consistently identified predictors of infectious deterioration include comorbidity burden, a positive preoperative urine culture, ureteral stent exposure and prolonged dwell time, hydronephrosis, stone burden, operative duration, and surrogate markers of intrarenal pressure. Scenario-specific prediction tools are available for emergency triage, post-decompression reassessment, and postoperative… More >

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ARTICLE

Joshua Mark Lohri^1,*, Jacqueline Christine Fannin²
Canadian Journal of Urology, DOI:10.32604/cju.2026.081702
Abstract Background: Pelvic organ prolapse is increasingly prevalent, contributing to a growing surgical burden with an aging population. This study compared patient characteristics, perioperative outcomes, and one-year recurrence and reoperation rates of robotic sacrocolpopexy performed by urologists versus gynecologists to evaluate whether surgical specialty influences outcomes. Methods: We conducted a retrospective observational study of patients undergoing robotic sacrocolpopexy (n = 185) for pelvic organ prolapse between November 2016 and December 2024. Cases were identified using ICD-10 code N81 and CPT code 57425 and grouped by surgical specialty and inpatient versus outpatient status. A subgroup analysis evaluated patients… More >

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ARTICLE

Yudhistira Pradnyan Kloping¹, Dimas Panca Andhika^2,3, Zakaria Aulia Rahman^2,3, Putu Kurnia Darma^2,3, Anthony Chi-Fai Ng⁴, Lukman Hakim^2,5,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.080627
（This article belongs to the Special Issue: Advances in Molecular Imaging and Targeted Therapies for Prostate Cancer)
Abstract Background: The use of N-methyl-D-aspartate (NMDA) receptor antagonists for anesthesia is common, but their potential for other purposes is currently being studied. Ketamine, the most prescribed NMDA blocker, is currently used to treat depression. The growing use of these drugs as outpatient treatments highlights their potential for other areas. Several studies suggest that NMDA receptors are expressed in malignant adenocarcinoma cells, including prostate cancer. Therefore, we aimed to evaluate the effects of ketamine on viability and apoptosis in castration-resistant prostate cancer (CRPC) cells. Methods: PC3 cell line, taken from a bone metastasis of a grade… More >

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ARTICLE

Lodewikus P. Vermeulen^1,*, Flavio V. Ordones¹, Peter J. Gilling¹, Homi Zargar², James Symons³, Janelle Brennan⁴, Shahram S. Gholami⁵
Canadian Journal of Urology, DOI:10.32604/cju.2026.078938
（This article belongs to the Special Issue: Recent Advances in Urology: Innovations Across the Spectrum of Care)
Abstract Backgrounds: Paclitaxel-eluting bioabsorbable im-plants are a novel office-based intraprostatic drug elution (IPDE) therapy for men suffering from lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). The objective of this study is to evaluate the safety and feasibility of IPDE in a dose escalation clinical trial. Methods: We report the initial low-dose cohort results from a first-in-human dose escalation study across four sites in Australia and New Zealand (NCT06136819). IPDE therapy of the first five participants was performed, each patient received a one-time dosing of 4–6 bioabsorbable implants in the initial low-dose cohort. Results: More >

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Jamil Almohtasib, Lucia Elting, Ignacio San Francisco, Ra’ad Al-Faouri, Agustin Perez-Londoño, Andrew Wagner, Boris Gershman, Peter Chang, Aria F. Olumi^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.078095
（This article belongs to the Special Issue: Non-Radical Treatment for Prostate Cancer: A New Approach)
Abstract Background: Follow-up after High-Intensity Focused Ultrasound (HIFU) for prostate cancer lacks standardization, particularly regarding the role and accuracy of imaging and biopsy. Therefore, this study aimed to evaluate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) following HIFU therapy for intermediate-risk prostate cancer. Methods: Patients with biopsy-proven, intermediate-risk, localized prostate cancer were offered HIFU therapy. Prior to treatment, patients underwent template prostate biopsy, prostate MRI and genomic testing (OncotypeDX). Baseline International Prostate Symptom Score, Prostate-specific antigen, and Prostate Imaging-Reporting and Data System (PI-RADS) scores were recorded. Clinically significant prostate cancer (csPCa) was defined as… More >

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HOW I DO IT

Jonah Marshall^1,*, Olga Kirk², Yaron Sternbach³
Canadian Journal of Urology, DOI:10.32604/cju.2026.077670
Abstract The gold standard of managing the retrieval of inferior vena cava (IVC) filters has been an endovascular approach with snare techniques. At times, complete removal cannot be performed, and an open surgical approach has been undertaken. Robotic technology allows for an alternative approach to a retained IVC filter retrieval. There are only a few documented cases of this approach in the literature to date, and we present a novel approach utilizing the lower abdominal retroperitoneal approach. We describe the approach, as well as provide some suggestions, which may facilitate both the higher and lower approaches More >

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REVIEW

Zhuoming Xu^1,#, Jialu Xin^2,#, Weiqing Xu¹, Guicheng Liu¹, Liang Dong^2,*, Xujun Yu^3,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.077071
Abstract The centrosome is essential for preserving germ-cell integrity across evolution and for safeguarding paternal inheritance in humans. This evolutionarily conserved subcellular structure serves as the primary microtubule-organizing center in mammalian cells, coordinating the assembly of microtubule-based structures that mediate sperm head–neck coupling, flagellar biogenesis and other cytoskeletal rearrangements required for spermatogenesis and early embryogenesis. A rapidly expanding literature now implicates centrosomal proteins in male infertility: structural or functional defects of the centrosome consistently correlate with aberrant sperm morphology, motility failure and distinct pathological phenotypes. The research objective is to review the role of centrosomal protein… More >

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CASE REPORT

Bernardo Rocco¹, Angelo Totaro¹, Simone Assumma¹, Enrico Panio¹, Filippo Gavi¹, Simona Presutti¹, Pierluigi Russo^1,2, Giovanni Panico³, Filippo Turri¹, Nazario Foschi¹, Anna Fagotti³, Maria Chiara Sighinolfi^1*
Canadian Journal of Urology, DOI:10.32604/cju.2026.067267
Abstract Background: Robotic radical cystectomy has demonstrated non-inferiority compared with the open approach; however, bowel and uretero-enteric anastomoses remain challenging and prone to complications. Indocyanine Green (ICG) is a fluorescent dye that emits near-infrared light after intravenous administration and enhances the evaluation of tissue perfusion, lymphatic mapping, and anatomical delineation. By allowing real-time assessment of tissue viability, ICG may reduce the risk of anastomotic leakage and ischemic complications. ICG fluorescence was first integrated into the Da Vinci system through Firefly technology, while the Hugo™ Robotic-Assisted Surgery (RAS) platform initially lacked ICG compatibility. We report a preliminary urological… More >

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REVIEW

Saveliy Kelebeyev, Kristian Black, Raevti Bole, Petar Bajic^*
Canadian Journal of Urology, DOI:10.32604/cju.2026.079756
Abstract Peyronie’s disease (PD) is an acquired connective tissue disorder characterized by fibrotic plaque formation within the tunica albuginea that can significantly impair sexual function and quality of life. Despite being described over 280 years ago, its pathophysiology remains incompletely understood, contributing to variable and often limited efficacy of nonsurgical therapies. PD is a multifactorial condition resulting from the interaction of mechanical injury, metabolic comorbidities, and individual susceptibility, with genetic contributions supported by familial clustering, associations with fibroproliferative disorders, and emerging cytogenetic and epigenetic data. At the molecular level, PD reflects dysregulated wound healing characterized by… More >

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ARTICLE

Daniele Cignoli^1,*, Sara Carminati², Giuliana Martello¹, Daniele Robesti³, Paolo Barzaghi¹, Michele Catellani¹, Stefano Corti¹, Giovanni La Croce¹, Luigi Filippo Da Pozzo^1,2, Marco Roscigno^1,2
Canadian Journal of Urology, DOI:10.32604/cju.2026.078431
（This article belongs to the Special Issue: Advances in Microultrasound Imaging for Prostate Cancer)
Abstract Objectives: Multiparametric magnetic resonance imaging (mpMRI) represents a cornerstone of prostate cancer (PCa) diagnosis; however, it is not without limitations, particularly in terms of specificity and real-world implementation. High-resolution 29-MHz micro-ultrasound (microUS) has recently emerged as a complementary imaging modality, with the potential to enhance lesion detection and refine mpMRI-based diagnostic pathways. This study aims to compare the diagnostic performance of microUS and mpMRI for the detection of clinically significant prostate cancer (csPCa), and to evaluate the clinical value of integrating microUS into mpMRI-based diagnostic pathways.
Methods: This single-center retrospective study included 457 men undergoing prostate biopsy… More >

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MINI REVIEW

Skyler Howell^1,*, Mohit Khera²
Canadian Journal of Urology, DOI:10.32604/cju.2026.072758
Abstract Sexual dysfunction, encompassing entities like erectile dysfunction, Peyronie’s disease, ejaculatory and orgasmic disorders, and female sexual dysfunction, is highly prevalent and substantially impacts quality of life. While medical and surgical treatments have significantly advanced in the last half-century, they may not address underlying causes or contextual elements that contribute to these multifactorial disorders. This perspective synthesizes evidence-based, holistic approaches to prevention and management of sexual dysfunction, emphasizing their role in preserving “Sexspan”, the period of life characterized by satisfying sexual function and intimacy. We narratively review high-level evidence connecting two broad domains that support sexual… More >

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ARTICLE

David A. Ostrowski^1,2, Joseph R. Logan^3,4,5, Austin Thompson⁶, Reiley Broms³, Thomas Syphan⁶, Maria Antony³, Mandy Rickard⁷, Lauren Erdman^8,9, Dennis Head¹⁰, Jessica H. Hannick⁶, Lynn L. Woo⁶, Frederick D. Grant¹¹, Neeta D’Souza³, Satish E. Viswanath¹², Chris A. Flask¹³, Armando J. Lorenzo⁷, Yong Fan¹⁴, Gregory E. Tasian^2,3,5, John K. Weaver^6,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.077246
（This article belongs to the Special Issue: Advancing the Diagnosis and Treatment of Urological Diseases through Big Data)
Abstract Objectives: This study aims to build machine learning models to analyze Technetium-99m mercaptoacetyltriglycine (MAG3) renal scans and clinical variables from patients with antenatal hydronephrosis (ANH) with concern for ureteropelvic junction obstruction (UPJO) and equivocal initial MAG3 renal scans to predict the risk of renal complication development. Methods: A retrospective cohort of patients under 1-year-old with ANH concerning for UPJO with an equivocal MAG3 renal scan evaluated at our institution from January 2009 to June 2021 was identified. Equivocal renal scans were defined as studies where the affected kidney demonstrated split function greater than 39%, and… More >

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ARTICLE

Rohan G. Bhalla¹, Sasha J. Vereecken^1,*, Nate Coddington², Ty T. Higuchi¹, Brian J. Flynn¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.076096
（This article belongs to the Special Issue: Advances in Robot-Assisted Urological Surgery: Innovations, Outcomes, and Future Perspectives)
Abstract Background: The use of robotic-assisted laparoscopic (RAL) surgery in functional and reconstructive urology (FRU) has exponentially grown and has become standard of care over the past decade. We aimed to compare our experience adopting RALsurgery in FRU with current practice patterns and to discuss the implications of the RAL platform for the future of genitourinary reconstructive surgery (GURS) training. Methods: We reviewed case logs of two GURS urologists and identified RAL cases from 2012 to 2024. Cases were categorized into: lower urinary tract (LUT), upper urinary tract (UUT), urogynecology and reconstructive pelvic surgery (URPS), fistula,… More >

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ARTICLE

Antonio Benito Porcaro, Maria Angela Cerruto, Riccardo Bertolo^*, Michele Boldini, Alessandro Veccia, Riccardo Rizzetto, Francesco Artoni, Andrea Franceschini, Alberto Baielli, Francesca Montanaro, Sonia Costantino, Matteo Brunelli, Salvatore Siracusano, Alessandro Antonelli
Canadian Journal of Urology, DOI:10.32604/cju.2026.076673
Abstract Backgrounds: Multiparametric MRI (mpMRI) and the PI-RADS scoring system play a central role in the detection and risk stratification of prostate cancer; however, the prognostic significance of a single visible index lesion remains incompletely defined. The aim of the study was to evaluate associations of one single visible PI-RADS (Prostate Imaging–Reporting and Data System) index lesion varying from 3 to 5 with adverse pathology after robotic surgery and with clinical prostate cancer (PCa) including EAU (European Association of Urology) prognostic risk classes. Materials and methods: The study included only cases with one single visible PI-RADS lesion… More >

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ARTICLE

Leonardo O. Reis^1,2,3,4,*, Matheus B. Santos^1,2, Caio V. Suartz^4,5, Ana Claudia G. de Paula⁶, Gabriela R. Barbosa^2,3,4, Adriano Cintra², Fabiano A. Simões², Fábio Guimarães², João C. C. Alonso², Ronald F. Rejowski², Walker W. Laranja²
Canadian Journal of Urology, DOI:10.32604/cju.2026.078361
Abstract Objectives: Sexually transmitted infections (STIs) remain a major global public health challenge. Urology consultations often serve as an entry point for men presenting with genitourinary symptoms that may be associated with underlying STIs. This work aims to describe epidemiological characteristics and identify behavioral and clinical predictors associated with self-reported lifetime STIs and laboratory-confirmed syphilis among men attending routine urology consultations in primary healthcare settings. Methods: This cross-sectional study comprised two analytically independent components of routine urological patients in São Paulo, Brazil. The first included 2582 men aged 34–55 years who completed a standardized sociodemographic and… More >

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ARTICLE

Guowei Du^1,#, Jianhuai Chen^2,#, Heng Wang³, Shanshan Chen¹, Yanting Wang¹, Jing Wang¹, Guangzhao Yang⁴, Siwen Liu^5,*, Xuanyi Chen^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.078745
（This article belongs to the Special Issue: Metabolic and Lifestyle Influences on Urologic Health)
Abstract Background: Obesity is a recognized risk factor for male infertility, yet the involvement of the hypothalamic-testicular axis and nuclear factor kappa-B (NF-κB)-mediated inflammation remains incompletely defined. This study aimed to investigate whether diet-induced obesity is associated with alterations in the hypothalamic-testicular NF-κB signaling axis and spermatogenesis through integrated transcriptomic analysis and clinical meta-analysis. Methods: Testicular single-cell RNA-seq and hypothalamic transcriptomic data from diet-induced obese mice were integrated to identify cell-type-specific transcriptional changes. The analyses included differential expression, pathway enrichment, and NF-κB activity scoring based on target gene expression. Mechanistic findings related to steroidogenesis and germ-cell… More >

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ARTICLE

Tatsuya Shimomura^1,*, Masaya Murakami^1,2, Kanako Kasai^1,2, Yu Imai^1,2, Yuzo Inaba^1,2, Takahiro Kimura¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.076841
Abstract Background: Neuroendocrine prostate cancer (NEPC) is a deadly condition, with a median overall survival of less than one year after diagnosis. Although clinical trials are ongoing, an established treatment strategy for NEPC has not yet been developed. A recent clinical trial, RADIANT-4, showed that treatment with everolimus significantly improved survival in patients with progressive neuroendocrine tumors of the lung or gastrointestinal tract. This study evaluated the efficacy of everolimus against neuroendocrine differentiated prostate cancer as an initial investigation. Methods: Five patients with neuroendocrine differentiated prostate cancer were treated with everolimus (10 mg daily). In our… More >

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ARTICLE

Miguel Arrabal-Martin^1,2, Maria Isabel Martinez-Sanchez¹, Laura Jerez-Fernandez¹, Marta Sacristan-Ruiz¹, Maria Jose Garcia-Ortega¹, Andrea Maria Hernandez-Perez³, Miguel Angel Arrabal-Polo^1,2,*, Alberto Zambudio-Munuera¹, Mercedes Nogueras-Ocaña¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.076194
（This article belongs to the Special Issue: Advances and Evolving Techniques in Functional Urology)
Abstract Background: Posterior tibial nerve stimulation (PTNS) using the Urgent PC device has been shown to improve symptoms of overactive bladder (OAB). In this context, non-invasive autonomic nervous system neuromodulation using microcurrents (NESA), delivered via the NXsignal device, has emerged as a potential alternative therapy. The study aimed to evaluate the initial efficacy of NESA in patients with an overactive bladder. Methods: We conducted a prospective, non-randomized study comparing microcurrent neuromodulation (NESA) with PTNS in 60 consecutively recruited patients, evaluating changes in clinical bladder diary parameters and urodynamic findings after 12 treatment sessions. The main variables… More >

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ARTICLE

Giuseppe Pallotta^1,#, Maria Chiara Sighinolfi^1,#,*, Simona Presutti¹, Antonio Silvestri¹, Ela Patel², Stefano Terzoni³, Stefano Abed¹, Daniele Fettucciari¹, Vincenzo Cavarra¹, Filippo Gavi¹, Giovanni Filomena¹, Francesco Rossi¹, Domenico Varacalli¹, Marco Montesi¹, Nicoletta Testori¹, Arianna Del Proposto¹, Simone Assumma¹, Enrico Panio¹, Bernardo Rocco¹
Canadian Journal of Urology, DOI:10.32604/cju.2026.076218
（This article belongs to the Special Issue: Advances in Robot-Assisted Urological Surgery: Innovations, Outcomes, and Future Perspectives)
Abstract Background: The introduction of multimodular robotic platforms has raised concerns regarding operating room (OR) efficiency compared to established single-boom systems. This issue is particularly relevant in high-volume robotic programs, where OR turnover time (ORTT) represents a key determinant of productivity and cost-effectiveness. The aim of this study was to compare OR turnover time and closure-to-incision time between a multimodular robotic system (Hugo™ RAS) and a single-boom system (Da Vinci^® Xi) during robot-assisted laparoscopic radical prostatectomy in a standardized, high-volume setting. Methods: We conducted a single-center retrospective cohort study comparing ORTT and closure-to-incision time (CTIT) between the… More >

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MINI REVIEW

Arianna Tumminello¹, Giuseppe Reitano¹, Elisa Tonet¹, Giovanni Basso¹, Felice Crocetto², Iliana Bednarova³, Francesca Caumo³, Matteo Todisco⁴, Alberto Lauro⁴, Carmelo Lacognata⁴, Francesca Galuppini⁵, Giorgio De Conti⁴, Giovanni Betto¹, Massimo Iafrate¹, Giacomo Novara¹, Fabrizio Dal Moro¹, Fabio Zattoni^1,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.073468
（This article belongs to the Special Issue: Advancing Early Detection of Prostate Cancer: Innovations, Challenges, and Future Directions)
Abstract 5-alpha reductase inhibitors (5-ARIs) are widely prescribed for the management of benign prostatic hyperplasia and are known to induce morphological and metabolic changes in prostatic tissue. This narrative review summarizes current evidence on the impact of 5-ARI therapy on multiparametric magnetic resonance imaging (mpMRI) findings and the potential clinical implications. While some studies report reduced discrimination on T2-weighted and apparent diffusion coefficient (ADC) metrics after long-term exposure, others suggest improved lesion visibility due to a more homogeneous benign background. Most studies found no significant difference in the Prostate Imaging Reporting and Data System (PI-RADS) lesion More >

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ARTICLE

Francesco Del Giudice^1,2,3,*, Roberta Corvino¹, Valerio Santarelli¹, Eleonora Razeto¹, Stefano Impaloni¹, Sarah Carvalho Ribeiro¹, Matilde Verde¹, Bernardo Rocco⁴, Ettore De Berardinis¹, Jan Laszkiewicz⁵, Benjamin I. Chung², Amir Khan⁶, Yasmin Abu-Ghanem³, Elsie Mensah³, Ramesh Thurairaja³, Muhammad Shamim Khan³, Rajesh Nair³
Canadian Journal of Urology, DOI:10.32604/cju.2026.079662
（This article belongs to the Special Issue: Advances in Diagnosis and Management of Bladder Cancer: From Molecular Insights to Therapeutic Innovations)
Abstract Objectives: White light cystoscopy (WLC) remains the standard tool for the diagnosis and surveillance of bladder cancer (BC), but it may miss up to 20% of lesions, highlighting the potential role of artificial intelligence (AI) assisted systems such as CystoSmart™. The study aims to evaluate the sensitivity and specificity of CystoSmart™ in detecting papillary and flat lesions, using histopathology as the reference standard. Methods: This is a prospective observational, non-interventional study with retrospective AI application, led by “Sapienza” University of Rome. Patients undergoing primary or follow up WLC for suspected BC will be enrolled and… More >

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ARTICLE

Carly Sears¹, Richard Wassersug^2,*, Eric Brown³, Paul Schellhammer⁴, Robert Watson⁵
Canadian Journal of Urology, DOI:10.32604/cju.2026.075285
Abstract Backgrounds: The PATCH/STAMPEDE trial [NCT00303784] in the UK has established that transdermal estradiol (tE2) offers equally effective cancer control for systemic prostate cancer (PCa) as standard androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone agonists alone or combined with androgen receptor pathway inhibitors. ADT with tE2 provides significantly better quality of life. However, there are no tE2 products specifically licensed for PCa patients and little evidence on whether PCa patients would be interested in using tE2 for ADT compared to other ADT options. Given that background, we used an online survey to explore PCa patients’… More >

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ARTICLE

Ahmet Halis¹, Yasar Pazir^2,*, Abdulkadir Ozmez³, Huseyin Besiroglu⁴, Mustafa Kadihasanoglu⁴
Canadian Journal of Urology, DOI:10.32604/cju.2026.077124
（This article belongs to the Special Issue: Advances in Men's Health: The Latest in Andrology, Male Infertility, and Sexual Medicine)
Abstract Objective: Varicocele remains a major reversible cause of male infertility; however, the studies that have most strongly influenced clinical practice and research trends have not been systematically analyzed. This study aimed to evaluate the characteristics, trends, and scientific impact of the top 100 most-cited (T100) articles on varicocele using bibliometric methods. Methods: A comprehensive search was performed in the Web of Science Core Collection database using keywords related to varicocele. Articles were ranked according to citation number, and the T100 articles were included for bibliometric evaluation. Results: The T100 articles were released between 1980 and 2017,… More >

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REVIEW

Vasileios Sakalis^1,2,*, Eftichia Chatzigriva^1,2, Karl H. Pang³, Bhavan P. Rai⁴, Isaak Filippidis^1,2, Lisa Moris⁵, Maria Chalkidou^1,2, Yuhong Yuan⁶, Michael Bussmann⁷, Dimitrios Papanikolaou⁸, James N’Dow⁹, Muhammad Imran Omar⁹
Canadian Journal of Urology, DOI:10.32604/cju.2026.077632
（This article belongs to the Special Issue: AI, Radiomics, and Radiogenomics in Urologic Oncology: Toward a New Era of Precision Imaging)
Abstract Objectives: Artificial Intelligence (AI) has the potential to transform clinical medicine by enhancing diagnostic precision, prognostic accuracy, and personalized decision making. In urological oncology, AI technologies are increasingly integrated across diagnostic, prognostic, and therapeutic pathways. This overview of systematic reviews aims to synthesise the current evidence on the performance and clinical utility of AI applications in urological malignancies. Methods: A systematic search was conducted of major bibliographic databases from 1974 to October 2024 to identify systematic reviews (SRs) evaluating AI-based models in urological cancers. We followed the Cochrane methodology of Overviews of Reviews. Outcomes of… More >

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ARTICLE

Ahnaf J. Ahmed¹, Austin J. Marrah², Trenton G. Mayberry², Braydon C. Cowan², Mark R. Wakefield^2,3, Yujiang Fang^1,2,3,*
Canadian Journal of Urology, DOI:10.32604/cju.2026.077527
Abstract Atherosclerotic renal artery stenosis (ARAS) is a significant cause of secondary hypertension and kidney injury with important cardiovascular consequences. This review briefly discusses the pathophysiology of ARAS, evaluates in-depth the diagnostic performance of duplex ultrasound, computed tomography angiography, and magnetic resonance angiography, and synthesizes results from major randomized trials and observational studies to explore current treatment options. The objective is to define the current diagnostic and therapeutic landscape of ARAS in a manner that supports evidence-based clinical decision making, and identify which treatment modality may be appropriate based on clinical presentation. The preference for optimized… More >

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