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  • Open Access

    REVIEW

    Sexual dysfunction in men with fibromyalgia: a systematic review with structured narrative synthesis (SWiM-Compliant)

    Indiamara Deggerone1,*, 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 >

  • Open Access

    REVIEW

    PSMA PET imaging in localized prostate cancer and biochemical recurrence: current evidence and clinical applications

    Emmanouil Panagiotidis1, Filippos Koinis2, George Angelidis1,*, 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 >

  • Open Access

    REVIEW

    Artificial intelligence (AI)-based models for bladder cancer (BC) endoscopic detection: a systematic 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 Giudice2,5,*
    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 >

  • Open Access

    ARTICLE

    Feasibility and user perception of a hydrogel-based platform for introductory LEP training

    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 >

  • Open Access

    CASE REPORT

    Robotic transvesical excision of large bladder leiomyoma: a case report

    Matthew Kwon1,2,*, 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 >

  • Open Access

    HOW I DO IT

    Intrarenal pressure in percutaneous nephrolithotomy, from theory to practice

    Andres Benitez-Filselcker1, Felipe Aguila1,2, Cristobal Avila1, Tomas Punte1,3, Jaime Barahona4, Fernando Marchant1,2,*
    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 >

  • Open Access

    ARTICLE

    Efficacy of a flexible navigable suction access sheath during retrograde intrarenal surgery for 1–3 cm renal calculi: a comparative analysis

    Hao Wang1,#, Yijie Xie1,#, Meixuan Ding2,#, He Gong3, Qi Zheng3, Jiaxin Zheng3, Bo Duan3, Tao Wang3,*, Peide Bai3,*, Bin Chen1,*
    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 (nMore >

  • Open Access

    ARTICLE

    The significance of prostate-specific antigen density and free prostate-specific antigen density in the early detection of prostate cancer in individuals experiencing acute urinary retention

    Qi Wang1,2,3,4,5, Jiayan Xin3,4,5,6, Minghao Zhang2,3,4,5, Yong Wang1,*
    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 >

  • Open Access

    MINI REVIEW

    Overlooked and undertreated: the role of female sexual dysfunction in male sexual health outcomes

    Mallory Pine1, Marium Ansari1, Alise Hale1, Ramzy Burns2,*, 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 >

  • Open Access

    CASE REPORT

    Management of a large mid-ureteral stone using flexible vacuum-assisted ureteral access sheath and holmium laser lithotripsy: a case report

    Ruiyang Hu1, Nianben Chen2, Jingxing Wu2, Wenjun Ma3, Youjin Cai3, Qinglin Hu3,*
    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 >

  • Open Access

    ARTICLE

    Index density of positive biopsy cores is associated with post-robotic cancer progression

    Antonio Benito Porcaro1, Maria Angela Cerruto1,*, 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 >

  • Open Access

    ARTICLE

    Detection rates and disease patterns of PSMA PET/CT in prostate cancer at a national tertiary referral center: a real-world descriptive study

    Justine Grangeret1,*, 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 >

  • Open Access

    REVIEW

    Beyond grafting: a systematic scoping review on tunica-preserving surgical innovations for Peyronie’s disease

    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 >

  • Open Access

    ARTICLE

    Evaluating surgical smoke in laser-assisted laparoscopic partial nephrectomy with a novel handle: an in Vitro study

    Long Ma1, Tao Li1, Ruohao Sun2, Quan Du2, Dali Jiang3, Dalin He3, Xiaoliang Fu2, Nan Li2,*, Xiaofeng Xu2,*, Guoxiong Liu2,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.070096
    Abstract Objectives: Lasers show promising application in partial nephrectomy due to their excellent hemostatic effect. This study aimed to evaluate the suction effect of the novel laser operating handle on the smoke generated by a 980-nm diode laser (DL) and a 532-nm potassium-titanyl-phosphate (KTP) green laser (GL) in laparoscopic partial nephrectomy (LPN) and to analyse the surgical smoke generated by the laser treatment. Methods: Fresh porcine kidneys were purchased from a slaughterhouse. Electrocoagulation knife (EK), ultrasonic knife (UK), DL, and GL were utilised in LPN. The operation time and the composition and concentration of the surgical… More >

  • Open Access

    ARTICLE

    Interaction effects of age and abstinence duration on semen quality

    Guowei Du1,#, Jianhuai Chen2,#, Heng Wang3, Shanshan Chen1, Yanting Wang1, Jing Wang1, Guangzhao Yang4, Siwen Liu5,*, Xuanyi Chen1,*
    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 >

  • Open Access

    REVIEW

    An evolving arsenal: new hope in fighting advanced prostate cancer

    Elijah Vanderkamp1,#, Jacob M. Parker1,#, Mark R. Wakefield2,3, Yujiang Fang1,2,3,*
    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 >

  • Open Access

    ARTICLE

    Equal short-term oncological outcome after secondary resection despite intraoperative upgrading in nerve-sparing prostatectomy under NeuroSAFE control

    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 >

  • Open Access

    ARTICLE

    Comparison of patient-reported outcomes between supraumbilical and transumbilical camera port placement in robot-assisted laparoscopic prostatectomy: a prospective randomized trial

    Ryuta Tanimoto1,*, 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 >

  • Open Access

    ARTICLE

    450-nm blue laser vaporization versus transurethral resection of the prostate for benign prostatic hyperplasia: a retrospective comparative study

    Nana Liu1,2, Jinjin Zhang2, Wanli Liu2, Xiangbo Chen2,*, Baoli Li1,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.084512
    Abstract Background: Transurethral resection of the prostate (TURP) remains the standard surgical treatment for benign prostatic hyperplasia (BPH), whereas laser-based procedures have increasingly been adopted as alternatives because of their potential advantages in hemostasis and postoperative recovery. This study compared coagulation depth, perioperative outcomes, postoperative complications, and short-term functional outcomes between 450-nm blue laser vaporization of the prostate (BVP) and TURP. Methods: This retrospective single-center study included 260 patients with BPH who underwent either TURP (n = 110) or BVP (n = 150). Coagulation depth was compared between the two procedures using an ex vivo porcine kidney… More >

  • Open Access

    ARTICLE

    Female urethral surgery: a single-referral-center experience with practical tips and tricks

    Elisa Berdondini1, Ahmed Eissa2, Mauro Silvani1, Andrea Margara1, Mauro Gacci3, Salvatore Voce4, Giulio Reale4, Juan Ignacio Martinez-Salamanca5, Giuseppe Maiolino5,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.074216
    (This article belongs to the Special Issue: Female Urethral Reconstruction: Tips And Tricks)
    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 >

  • Open Access

    ARTICLE

    Genetic variants in the STIM1–ORAI1 calcium entry pathway and susceptibility to calcium urolithiasis

    Jinglai Lin1,2,3,#, Dengqiang Lin1,2,3,#, Zhun Wu4, Chao Huang4, Jinchun Xing4,*, Bin Chen4,*, Jiaxin Zheng4,*
    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 >

  • Open Access

    EDITORIAL

    The 10,000 Hour Rule, Robotics and the Evolving Lifespan of a Urologic Career

    Kevin R. Loughlin
    Canadian Journal of Urology, DOI:10.32604/cju.2026.085422
    Abstract This article has no abstract. More >

  • Open Access

    ARTICLE

    Transperineal laser ablation for high-volume benign prostatic hyperplasia: a prospective study of efficacy and safety

    Antonio Ruffo1, Fabio Esposito2, Vincenzo Maria Altieri1, Ester Illiano3, Lorenzo Spirito4, Valerio Santarelli5, Francesco Del Giudice5,*, 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 >

  • Open Access

    ARTICLE

    Comparative predictive value of 3D stone volume versus maximal diameter for retrograde intrarenal surgery success: a prospective clinical analysis

    Kemal Ertaş1,*, 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 >

  • Open Access

    ARTICLE

    Ergonomic strain during retrograde intrarenal surgery: a prospective observational study

    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 Manfredi1,*, 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 >

  • Open Access

    REVIEW

    Surgical implications of TURBT in an aging bladder cancer population

    Etan Eigner1,2, Nicola Fazaa1,2, Ameer Nsair1,2, Melissa Atallah1,2, Gilad E. Amiel1,2, Azik Hoffman1,2, Kamil Malshy3,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.079599
    (This article belongs to the Special Issue: Bladder and Prostate Cancers and Clinical Trials in Urologic Oncology)
    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 >

  • Open Access

    REVIEW

    Unraveling the metabolic and autoimmune links to male infertility: a narrative review

    Nicholas W. Shely1, Jacob M. Parker1, Hayden J. Oyler1, Alexander C. Lien1, Bode T. Eisenmenger2, Mark R. Wakefield2,3, Yujiang Fang1,2,3,*
    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 >

  • Open Access

    REVIEW

    Systematic review of prostate cancer screening in Sub-Saharan Arica

    Mohamed Jalloh1,#,*, Louise Makau-Barasa2,#, 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 >

  • Open Access

    CASE REPORT

    Gracilis muscle flap for salvage repair of radiation-induced urethroperineal fistula after rectal cancer surgery: a case report

    Changhao Hou1,2,#, Ruihang Zhang1,2,#, Pengbo Luo3, Weidong Zhu1,2, Lujie Song1,2,*
    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 >

  • Open Access

    CASE REPORT

    The PET/CT manifestations of solitary fibrous tumor of the prostate with prostate cancer: a 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 >

  • Open Access

    ARTICLE

    Association between serum spermidine synthase levels and acquired premature ejaculation: a cross-sectional study

    Kemal Ertas1,*, 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 >

  • Open Access

    ARTICLE

    Real-world experience with steerable ureteroscopic renal evacuation using the second-generation CVAC system in a large multicenter institution

    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 >

  • Open Access

    REVIEW

    The role of micro-ultrasound in active surveillance for prostate cancer

    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 >

  • Open Access

    REVIEW

    Urosepsis prediction in endoscopic stone surgery: from models to practice

    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 >

  • Open Access

    ARTICLE

    An in vitro, proof of concept study utilizing a latex model to simulate assessment of urethral pressure profile to quantify tissue compliance and stricture detection

    Diboro L. Kanabolo1,*, Noah Roselli2, Emily Ji1, Yashwanth Nanda Kumar3, Neelesh A. Patankar4, Ziho Lee1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.079668
    Abstract Background: Retrograde urethrogram (RUG) remains the gold standard for diagnosing urethral stricture disease, however no widely available diagnostic modality currently quantifies stricture characteristics using cross-sectional area or tissue compliance. We hypothesized that pressure-derived metrics could improve diagnostic accuracy and guide treatment. We aimed to develop an in vitro latex urethra model to simulate “healthy” and “strictured” states and directly measure luminal pressure as an initial step toward compliance assessment. Methods: Ten 20-cm latex tubes were studied; five contained 1.5-cm simulated strictures. All tubes were clamped at both ends to prevent leakage. Strictures were created by clamping… More >

  • Open Access

    ARTICLE

    One-year recurrence and reoperation after sacrocolpopexy in a multispecialty retrospective cohort

    Joshua Mark Lohri1,*, 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 >

  • Open Access

    ARTICLE

    Ketamine induces viability reduction and increased apoptosis in castration-resistant prostate cancer (CRPC) cells: an in-vitro study on PC-3 cell line

    Yudhistira Pradnyan Kloping1, Dimas Panca Andhika2,3, Zakaria Aulia Rahman2,3, Putu Kurnia Darma2,3, Anthony Chi-Fai Ng4, Lukman Hakim2,5,*
    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 >

  • Open Access

    ARTICLE

    A first-in-human study of paclitaxel eluting bioabsorbable implants for the treatment of BPH symptoms

    Lodewikus P. Vermeulen1,*, 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 >

  • Open Access

    ARTICLE

    Performance of post-ablation MRI using PI-RADS scoring in detecting residual prostate cancer after HIFU: a single center experience

    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 >

  • Open Access

    HOW I DO IT

    How I do it: robotic approach to the vena cava removal of the IVC filter strut extruding through the cava to the right ureter

    Jonah Marshall1,*, 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 >

  • Open Access

    REVIEW

    The role of specific centrosomal protein dysfunctions in specific sperm defects

    Zhuoming Xu1,#, Jialu Xin2,#, Weiqing Xu1, Guicheng Liu1, Liang Dong2,*, Xujun Yu3,*
    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 >

  • Open Access

    CASE REPORT

    ICG-guided intracorporeal intestinal diversion with the Hugo™ RAS system following radical cystectomy: technological background and case report

    Bernardo Rocco1, Angelo Totaro1, Simone Assumma1, Enrico Panio1, Filippo Gavi1, Simona Presutti1, Pierluigi Russo1,2, Giovanni Panico3, Filippo Turri1, Nazario Foschi1, Anna Fagotti3, Maria Chiara Sighinolfi1*
    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 >

  • Open Access

    REVIEW

    A narrative review of pathophysiology and therapeutic concepts in Peyronie’s disease

    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 >

  • Open Access

    ARTICLE

    Comparison of micro-ultrasound and multiparametric magnetic resonance imaging in detecting clinically significant prostate cancer: a single-center experience

    Daniele Cignoli1,*, Sara Carminati2, Giuliana Martello1, Daniele Robesti3, Paolo Barzaghi1, Michele Catellani1, Stefano Corti1, Giovanni La Croce1, Luigi Filippo Da Pozzo1,2, Marco Roscigno1,2
    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 >

  • Open Access

    MINI REVIEW

    Lifestyle and contextual approaches for sexual dysfunction

    Skyler Howell1,*, 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 >

  • Open Access

    ARTICLE

    Random survival forest models predict renal complications in antenatal hydronephrosis

    David A. Ostrowski1,2, Joseph R. Logan3,4,5, Austin Thompson6, Reiley Broms3, Thomas Syphan6, Maria Antony3, Mandy Rickard7, Lauren Erdman8,9, 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. Tasian2,3,5, John K. Weaver6,*
    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 >

  • Open Access

    ARTICLE

    Robotics in functional and reconstructive urology: evolutionary institutional experience and current attitudes amongst practicing urologists

    Rohan G. Bhalla1, Sasha J. Vereecken1,*, 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 >

  • Open Access

    ARTICLE

    Association of one single visible mpMRI PI-RADS index lesion with prostate cancer adverse pathology at robot-assisted radical prostatectomy: a 505-patient study

    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 >

  • Open Access

    ARTICLE

    Epidemiology and predictors of positive serology for syphilis among men attending routine urological consultations

    Leonardo O. Reis1,2,3,4,*, Matheus B. Santos1,2, Caio V. Suartz4,5, Ana Claudia G. de Paula6, Gabriela R. Barbosa2,3,4, 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 >

  • Open Access

    ARTICLE

    Diet-induced obesity disrupts hypothalamic- testicular NF-κB signaling axis and impairs spermatogenesis: an integrated transcriptomic analysis and meta-analysis

    Guowei Du1,#, Jianhuai Chen2,#, Heng Wang3, Shanshan Chen1, Yanting Wang1, Jing Wang1, Guangzhao Yang4, Siwen Liu5,*, Xuanyi Chen1,*
    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 >

  • Open Access

    ARTICLE

    Administrating Everolimus against neuroendocrine differentiated prostate cancer, a preliminary experience

    Tatsuya Shimomura1,*, Masaya Murakami1,2, Kanako Kasai1,2, Yu Imai1,2, Yuzo Inaba1,2, 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 >

  • Open Access

    ARTICLE

    Neuromodulation with microcurrents versus posterior tibial nerve stimulation in the treatment of overactive bladder: a prospective comparative study

    Miguel Arrabal-Martin1,2, Maria Isabel Martinez-Sanchez1, Laura Jerez-Fernandez1, Marta Sacristan-Ruiz1, Maria Jose Garcia-Ortega1, Andrea Maria Hernandez-Perez3, Miguel Angel Arrabal-Polo1,2,*, 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 >

  • Open Access

    ARTICLE

    Operating room turnover times for radical prostatectomy: a single center retrospective comparison between multimodular and single-boom robotic systems

    Giuseppe Pallotta1,#, Maria Chiara Sighinolfi1,#,*, 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 >

  • Open Access

    MINI REVIEW

    Impact of 5-alpha reductase inhibitors on pre-biopsy MRI interpretation: effects on PI-RADS assessment and local staging

    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 Zattoni1,*
    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 >

  • Open Access

    ARTICLE

    Artificial intelligence software CystoSmart™ for papillary or flat lesions during bladder endoscopy: a prospective observational pilot study protocol

    Francesco Del Giudice1,2,3,*, 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 >

  • Open Access

    ARTICLE

    Transdermal estradiol for prostate cancer: how do patients compare it to other options for androgen deprivation therapy?

    Carly Sears1, Richard Wassersug2,*, 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 >

  • Open Access

    ARTICLE

    The top 100 most-cited articles in varicocele: a bibliometric analysis

    Ahmet Halis1, Yasar Pazir2,*, 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 >

  • Open Access

    REVIEW

    The role of artificial intelligence in urological malignancies: an overview of systematic reviews

    Vasileios Sakalis1,2,*, Eftichia Chatzigriva1,2, Karl H. Pang3, Bhavan P. Rai4, Isaak Filippidis1,2, Lisa Moris5, Maria Chalkidou1,2, 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 >

  • Open Access

    REVIEW

    Efficacy and safety of blue laser vaporization of the prostate for benign prostatic hyperplasia: a systematic review and meta-analysis

    Ren-Peng Yu1,2,3, Ou-Yang Song1, Hong Weng2,3, Yong-Bo Wang2, Bing-Hui Li2, Hao Zi4, Yu Hao1, Qiang Li1,*, Xian-Tao Zeng1,2,3,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.079426
    Abstract Objective: While novel 450 nm blue laser vaporization of the prostate (BLVP) has emerged as a promising treatment for benign prostatic hyperplasia (BPH), comprehensive evidence-based validation remains lacking. Therefore, this study aims to evaluate the efficacy and safety of BLVP for BPH. Methods: A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang database up to 1 September 2025 (an updated search was performed on 31 December 2025). Single-arm meta-analyses summarized the absolute efficacy and safety of BLVP. For the comparison of BLVP with… More >

  • Open Access

    ARTICLE

    Impact of the 2024 national medical fluid shortage on urologic practice in the United States: a cross-sectional survey

    Lucas B. Vergamini, Pedro Z. Padovani, Nicholas Choi, Wilson R. Molina, Donald Neff, David A. Duchene, Emily Elliott, Colby Souders, Maxton Thoman, Bristol B. Whiles*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.078800
    Abstract Objectives: In September 2024, Hurricane Helene caused extensive infrastructure damage in the United States, including severe disruption to a major Baxter sterile irrigation fluid manufacturing facility in North Carolina, leading to a nationwide shortage of sterile irrigation fluids used in surgical procedures. The objective of this study was to evaluate the impact of the nationwide sterile irrigation fluid shortage on urologic practice across the United States (U.S.) Methods: A descriptive, cross-sectional Research Electronic Data Capture (REDCap) survey was distributed to U.S. urologists. The questionnaire captured provider demographics, procedure delays, and practice/procedure modifications. Results: Ninety-five surgeons responded.… More >

  • Open Access

    ARTICLE

    Precision medicine meets vascular disease: innovations in atherosclerotic renal artery stenosis management

    Ahnaf J. Ahmed1, Austin J. Marrah2, Trenton G. Mayberry2, Braydon C. Cowan2, Mark R. Wakefield2,3, Yujiang Fang1,2,3,*
    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 >

  • Open Access

    ARTICLE

    Clinical spectrum of retroperitoneal Castleman disease: retrospective analysis of 59 cases in a single Chinese medical center

    Ting Zhu1,2,#, Junjie Tian3,#, Chuan Wang2, Zhishang Li2, Yanfeng Bai4, Shien Rao2, Ping Wang1,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.077709
    (This article belongs to the Special Issue: Advances in Molecular Imaging and Targeted Therapies for Prostate Cancer)
    Abstract Backgrounds: Castleman disease (CD) is a rare lymphoproliferative disorder. While its general clinical and pathological features are well-described, detailed data on retroperitoneal CD—a diagnostically challenging location—remain scarce. This study characterizes the clinicopathological profile, management, and long-term outcomes of retroperitoneal CD. The aim of this study is to clarify the clinical and therapeutic characteristics of retroperitoneal CD, and to provide practical evidence for its accurate diagnosis and individualized management in clinical practice. Methods: A retrospective analysis of 59 patients with pathologically confirmed retroperitoneal CD (September 2010–December 2025) was conducted at a single center. Patients were classified… More >

  • Open Access

    ARTICLE

    Prostatic morcellation after HoLEP Enucleation: efficiency and safety of Storz DrillCut vs. Jena Surgical Multicut Solo

    Lucas Bergadá1,*, Jonatan Reyes Olivera1, Federico Ignacio Tirapegui1, Christian Cristallo1, Diego Santillán1, Guillermo Montelli Yanzi1, Melissa Segura2, José Ramos1, Ignacio Tobia1, Mariano Sebastián González1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.077406
    (This article belongs to the Special Issue: Prostatic Enucleation: Current Evidence and Contemporary Practice)
    Abstract Backgrounds: Holmium laser enucleation of the prostate (HoLEP) is a widely accepted technique for treating benign prostatic hyperplasia (BPH). Developed in the 1990s, its safety and efficiency have improved with adenoma morcellation. Multiple morcellation devices exist, with oscillatory systems offering higher efficiency and safety. Notable among these are the DrillCut Storz™ (DC) and the Multicut SOLO Jena Surgical™ (MC). Currently, evidence on the efficiency of MC is limited, and no comparative analysis exists between oscillatory morcellators. The objective of this study is to compare the morcellation efficiency (g/min) of the DC and the MC. A… More >

  • Open Access

    ARTICLE

    Treatment of interstitial cystitis with intravesical instillation of recombinant human collagen type Ⅲ

    Xiaokai Shi, Li Zuo*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.074350
    Abstract Background: Interstitial cystitis (IC) is a chronic condition characterized by frequent urination, urgency, and pelvic pain. While its pathogenesis remains incompletely understood, the prevailing epithelial theory suggests that a defective glycosaminoglycan (GAG) layer increases bladder permeability, allowing urinary toxins to chronically stimulate the detrusor muscle and activate mast cells. Current therapies, such as intravesical hyaluronic acid instillation, have demonstrated limited efficacy. This study aimed to evaluate the feasibility of sterile recombinant human collagen type III (rHCIII) in mitigating bladder injury and its histological effects on urothelial integrity. Method: An IC rat model was established using… More >

  • Open Access

    ARTICLE

    Prostate volume on transrectal ultrasound: comparing ultrasounds performed by urologists to radiologists

    Marie-Elise Henckes, Ben Van Cleynenbreugel*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.072379
    (This article belongs to the Special Issue: Advances and Evolving Techniques in Functional Urology)
    Abstract Objectives: This study aims to assess the precision of transrectal ultrasound (TRUS) measurement of the prostate volume when performed by a urologist compared with a radiologist. To date, no prior research has directly compared the accuracy of prostate volume measurements between these two groups. Methods: A retrospective study was conducted using data from 307 men who underwent enucleation of the prostate between 2020 and 2022 in two Belgian hospitals (University Hospital Leuven and Maria Middelares Hospital [Ghent]). A comparison was made between the prostate volume measured on ultrasound pre-operatively and the measured resected volume after… More >

  • Open Access

    ARTICLE

    The estimated economic burden of urinary incontinence-related complications in older adults Canada

    Crystal Su1, Barrett Carley1, Casandra Gardner1, Andrea Shepherd1, Adrian Wagg2,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.079016
    Abstract Backgrounds: Urinary incontinence (UI) is increasingly prevalent, particularly in older adults. UI management is frequently under-resourced and is associated with the development of potentially avoidable complications, placing a significant burden on the patient and on the healthcare system. This study aimed to estimate the cost of UI-related complications in Canada. Methods: We conducted a comprehensive literature review using PubMed, Canadian Institute for Health Information (CIHI) data and citation mining to identify the prevalence of UI, UI-related complications, and associated treatment costs across each of acute care, long-term care (LTC), homecare and self/family care. UI-related complications… More >

  • Open Access

    ARTICLE

    Impact of leuprolide and goserelin on androgen suppression and adverse events in patients with prostate cancer

    Carla Simone Moreira Freitas1,2,*, Fabiana Rocha-Silva2, Thaís Almeida Marques-Silva2, Ana Carolina Ribeiro de Oliveira1, Sérgio Gomes da Silva1,3,4, Fabrizio dos Santos Cardoso1,5, Aleida Nazareth Soares2
    Canadian Journal of Urology, DOI:10.32604/cju.2026.069559
    Abstract Background: Androgen deprivation therapy (ADT) is widely employed in the management of advanced prostate cancer, with luteinizing hormone-releasing hormone (LHRH) agonists such as leuprolide and goserelin being common options. However, pharmacological and metabolic differences between these agents may affect the efficacy of hormonal suppression and adverse event profiles. This study compared the effects of leuprolide (22.5 and 45 mg) and goserelin (10.8 mg) on prostate-specific antigen (PSA) and testosterone reduction, as well as their metabolic and cardiovascular impacts and the influence of genetic variants on therapeutic response. Methods: A prospective, randomized, controlled study was conducted… More >

  • Open Access

    ARTICLE

    Autologous blood coagulum for fragment removal after ureteroscopic laser lithotripsy

    Tiffany R. Huang1,*, Bruce M. Gao1, Aymon Ali1, Mariah C. Hernandez1, Christopher D. Yang1, Jonathan Badin-Castro1, Carol Davis-Dao1,2, Helen Gao1, Seyedamirvala Saadat1, Seyed Amiryaghoub M. Lavasani1, Sohrab N. Ali1, Pengbo Jiang1, Roshan M. Patel1, Jaime Landman1, Ralph V. Clayman1,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.077477
    Abstract Background: Ureteroscopy is the recommended surgical treatment for renal stones less than two centimeters in diameter but often leaves residual fragments, increasing the risk of stone recurrence. Autologous blood coagulum is a potential adjunct to ureteroscopy for aiding fragment retrieval. This study evaluates the efficacy and efficiency of autologous blood coagulum assisted ureteroscopy compared to ureteroscopy and basketing for achieving absolute stone-free Grade A status. Methods: Following Institutional Review Board approval, a retrospective review of our comprehensive UC Irvine Minimally Invasive Surgery Ureteroscopy database consisting of 962 patients undergoing ureteroscopy between 2018 to 2025 identified… More >

  • Open Access

    ARTICLE

    Unintended consequences of antibiotic practices: the relationship between bowel preparation, prolonged prophylaxis, and ileus after radical cystectomy

    Sri Saran Manivasagam, Joseph Y. Clark, Jay D. Raman*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.078196
    (This article belongs to the Special Issue: Advances in Diagnosis and Management of Bladder Cancer: From Molecular Insights to Therapeutic Innovations)
    Abstract Objectives: Postoperative ileus (POI) after radical cystectomy (RC) is a common complication that carries significant morbidity. Prolonged antibiotic usage has been associated with an elevated risk of POI. The American Urological Association guidelines recommend that only a single dose of peri-procedural antibiotic prophylaxis is sufficient. This study aims to evaluate the association between oral antibiotic bowel preparation (ABP) and prolonged surgical antibiotic prophylaxis (SAP) (>24 h) with postoperative ileus (POI) following radical cystectomy (RC). Materials and Methods: A retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program procedure-targeted RC dataset was… More >

  • Open Access

    HOW I DO IT

    Button Cistostomy in pediatric population: a simplified mini-inivasive insertion technique

    Giovanni Mosiello1, Martina Monti1,2,*, Rebecca Pulvirenti1, Noemi Deanesi1,3, Antonio Maria Zaccara1, Chiara Pellegrino1, Maria Luisa Capitanucci1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.079335
    Abstract Pediatric patients with functional or anatomical lower urinary tract obstruction, including neurogenic bladder, require effective bladder drainage to maintain low intravesical pressures, prevent infections, and preserve renal function. Clean intermittent catheterization (CIC) is the standard approach, but it is not always feasible due to patient- or anatomy-related factors. In these cases, continent or non-continent urinary diversion techniques are considered. Among non-continent options, vesicostomy has traditionally been used but is associated with significant morbidity and long-term complications. The cystostomy button (CB), originally developed for enteral feeding, has emerged as a minimally invasive, catheterizable alternative for bladder More >

  • Open Access

    CASE REPORT

    Primary malignant melanoma of the female urethra: a case report and literature review

    Jianlin Xie1,#, Qingwei Zhang1,#, Jingde Wu1, Yingjun Ma2, Yujie Yan2, Xiande Huang3,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.076571
    Abstract Background: Primary urethral malignant melanoma is an extremely rare malignancy of mucosal origin. Its clinical manifestations are non-specific, often leading to misdiagnosis or delayed diagnosis. Due to its highly aggressive nature and propensity for early metastasis, patient prognosis is generally poor. Case description: This case report describes an 81-year-old Chinese female patient who presented to the Department of Urology at Gansu Provincial Hospital with the chief complaint of “a black mass at the external urethral meatus accompanied by urinary incontinence for two months. Physical examination revealed a dark, protruding mass at the external urethral orifice. Imaging… More >

  • Open Access

    REVIEW

    Artificial intelligence advances in cystoscopy and imaging for bladder cancer: a narrative review

    Usman Khalid1, Nikhil Shah1, Rajesh Kavia2, Deepak Batura2,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.074820
    (This article belongs to the Special Issue: Advancing the Diagnosis and Treatment of Urological Diseases through Big Data)
    Abstract Bladder cancer (BCa) diagnosis relies heavily on cystoscopy and imaging. Both have limited sensitivity and accuracy, particularly for muscle-invasive disease. Artificial intelligence (AI) has emerged as a promising tool for improving detection, grading, and staging by extracting imaging features that exceed human perception. We conducted a narrative review of peer-reviewed, English-language studies published between 2015 and 2025. We identified 75 articles and synthesized data from 35 key studies retrieved via PubMed, Google Scholar, Scopus, and Embase. Data were synthesized narratively, emphasizing diagnostic performance, clinical relevance, and study limitations. In cystoscopy, AI models achieved high accuracy… More >

  • Open Access

    REVIEW

    Ketamine uropathy: an update on pathophysiology, complications, and treatment options

    Derrick Tsang1, Ioannis Loufopoulos2, Konstantinos Kapriniotis1,*, Hannah Danbury2, Ioannis Manolitsis3, Stamatios Katsimperis3, Senol Tonyali4, Patrick Juliebø-Jones5, Lazaros Tzelves2, Neha Sihra6, James Green1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.075625
    (This article belongs to the Special Issue: Advances and Evolving Techniques in Functional Urology)
    Abstract Ketamine is a potent anaesthetic drug that has been used for decades. Ketamine abuse is an increasingly common problem, particularly among young people. Over one quarter of ketamine users will have at least one bothersome urological symptom, with heavier and longer use leading to potentially irreversible damage to the lower and upper urinary tract. Hence, this study carried out a narrative review focusing on ketamine-induced uropathy pathophysiology, clinical presentation, and treatment options. It was found that ketamine uropathy is an inflammatory condition affecting predominantly the bladder but also the upper urinary tracts. A hypersensitivity reaction… More >

  • Open Access

    ARTICLE

    Specialist consultation improves underdiagnosis of surgical adrenal incidentaloma: a TriNetX database investigation

    Aaron R. Hochberg1,2, Monika Shirodkar3, Brian H. Im1,2, Xiaoying Deng4, Fitsum T. Hailemariam4, Sohan S. Shah2, Rasheed A. M. Thompson1, Francisco Aguirre1, Patrick T. Gomella1, Mihir S. Shah1, Costas D. Lallas1, Adam R. Metwalli1,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.069461
    (This article belongs to the Special Issue: Integrating Innovation into Clinical Practice: Advances in the Multidisciplinary Care of Genitourinary Cancers)
    Abstract Objectives: Despite practice guidelines recommending hormonal testing for all cases of incidentally discovered adrenal adenomas (incidentalomas), only 30% of patients receive laboratory workup. This study sought to evaluate hormonal testing and adrenal surgery rates in incidentaloma patients seen by a specialist (endocrinologist, nephrologist, urologist, or general surgeon), compared to those not seen by a specialist. Methods: We identified incidentaloma cases by querying the TriNetX Research Network for all adult patients with an unspecified adrenal mass occurring within 1 month following abdominal imaging. We compared those seen by a specialist against those not following an incidentaloma… More >

  • Open Access

    REVIEW

    Diagnostic value of percutaneous sampling in Bosniak III–IV renal cysts: a systematic review and meta-analysis

    Attilio Barretta1,2,*, Angelo Mottaran1, Nicolas Carl2, Francesco Prata2,3, Sara Tamburini1,2, Edoardo Beatrici2, Mario De Angelis2,4, Francesco Cei2,4, Natali Rodriguez Peñaranda2, Francesco Pepillo2, Alessio Guidotti2, Vincenzo Cavarra2, Claudio Brancelli2, Pietro Pasquini2, Pietro Piazza1, Cristian Vincenzo Pultrone1, Hussam Dababneh1, Lorenzo Bianchi1, Alessandro Larcher4, Alexandre Mottrie2, Rocco Papalia3, Riccardo Schiavina1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.078354
    (This article belongs to the Special Issue: Technological Advances and Surgical Precision in Robotic Kidney Cancer Surgery)
    Abstract Objectives: Complex cystic renal lesions pose a significant diagnostic challenge in the preoperative assessment of malignancy. Although percutaneous renal mass biopsy is well established for solid tumours diagnosis, its role in cystic lesions remains controversial. This systematic review aims to evaluate the diagnostic performance, safety, and clinical impact of percutaneous sampling—fine-needle aspiration (FNA) and core needle biopsy (CNB)—in Bosniak III–IV renal cysts. Methods: A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [International Prospective Register of Systematic Reviews (PROSPERO) ID CRD420251124563]. PubMed/MEDLINE (Medical Literature… More >

  • Open Access

    CASE REPORT

    Renal Ewing sarcoma with an unusual presentation: a case report

    Felix Lübbersmeyer, Paula Lindfeld, Margit Fisch, Roland Dahlem, Markus Von Deimling*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.076969
    Abstract Backgrounds: Ewing Sarcoma (ES) is an aggressive pediatric bone tumor requiring multimodal treatment. Primary renal ES is extremely rare and often presents with nonspecific symptoms, potentially delaying diagnosis. Imaging aids detection, while histopathological and molecular analyses confirm the diagnosis. Case description: We report on a 31-year-old female who was initially treated for pyelonephritis. As computerized tomography suggested a malignant kidney tumor with an extensive inferior vena cava thrombus, nephrectomy and caval ligation were performed. Histopathology and further staging confirmed primary renal ES, which was subsequently treated with adjuvant polychemotherapy. Conclusions: The present case highlights the variable More >

  • Open Access

    REVIEW

    From bedroom to boardroom: erectile dysfunction as a window into cardiovascular health

    Andres H. Guillen Lozoya, Milad Bonakdarhashemi, Sevann Helo, Matthew Ziegelmann, Tobias Kohler*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.075775
    (This article belongs to the Special Issue: Advances in Men's Health: The Latest in Andrology, Male Infertility, and Sexual Medicine)
    Abstract Erectile dysfunction (ED) has evolved from a quality-of-life concern to a recognized marker of systemic vascular disease and an early harbinger of cardiovascular events. The Princeton IV Consensus underscores that men presenting with erectile dysfunction should be presumed at increased cardiovascular risk until proven otherwise, advocating integrated risk stratification and lifestyle optimization. Beyond established risk scores, advances in omics, vascular imaging, and digital health promise precision tools for early detection and prevention. This review aims to examine erectile dysfunction as an early marker of cardiovascular disease and to summarize current and emerging approaches to cardiovascular More >

  • Open Access

    ARTICLE

    Clinical and urodynamic indicators of non-response to OnabotulinumtoxinA in idiopathic overactive bladder

    Samer Shamout1, Hani Kabbara2, Claudia Covarrubias3, Jacques Corcos1, Lysanne Campeau1,2,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.073432
    (This article belongs to the Special Issue: Advances and Evolving Techniques in Functional Urology)
    Abstract Background: Onabotulinum toxin-A (BoNT/A) intradetrusor injection is an established, effective, and safe treatment for overactive bladder (OAB) refractory to anticholinergics. Although primary non-response to BoNT/A is infrequent, it remains clinically relevant. We investigated whether baseline clinical, demographic, or urodynamic characteristics could predict non-responders prior to treatment. Methods: A Retrospective analysis of 65 consecutive refractory idiopathic OAB (I-OAB) male and female patients treated with 100 U BoNT/A at Jewish General Hospital between 2005 and 2015 was conducted. Response defined as >30% increase in maximum cystometric bladder capacity (MCBC) at 12 weeks, confirmed clinically and through urodynamic… More >

  • Open Access

    ARTICLE

    Pathologic failure and salvage approaches following focal therapy for localized prostate cancer

    Samuel Tremblay1,#,*, Seyed Sajjad Tabei2,#, Shima Tayebi3, Benjamin H. Hinrichs4, Alon Lazarovich1, Jason Koehler3, Wei-Wen Hsu5, Sadhna Verma3, Abhinav Sidana1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.075779
    (This article belongs to the Special Issue: Non-Radical Treatment for Prostate Cancer: A New Approach)
    Abstract Background: Focal therapy (FT) is an emerging treatment modality for localized prostate cancer. However, limited data are available regarding the patterns of oncologic failure post-FT. This study aims to characterize the features of oncologic failure and salvage strategies following FT. Methods: Patients presenting with pathologic failure (PF) after receiving FT (cryotherapy, High-intensity focused ultrasound, or irreversible electroporation) for intermediate-risk prostate cancer were selected from a prospective registry between 2018 and 2023. All patients underwent protocol-based follow-up, including PSA testing, multiparametric MRI, and mandatory biopsy. The primary outcome was PF, defined as biopsy-confirmed Grade Group ≥2… More >

  • Open Access

    CASE REPORT

    At a glans: metastatic prostate cancer disguised as penile squamous cell carcinoma; a case report

    Ramya Narasimhan1, Kikuye Sugiyama2,*, Joanna Wang3, Ricardo Munarriz3, Carmen Sarita-Reyes1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.072310
    (This article belongs to the Special Issue: Prostate Cancer: Biomarkers, Diagnosis and Treatment)
    Abstract Background: The incidence rate of prostate adenocarcinoma in the United States was 112 per 100,000 in 2019. Men aged 65 to 74 years had a higher incidence rate (638 per 100,000), and 70% of the cases were detected locally (confined to the primary site) per the United States Cancer Statistics. While rare, prostate adenocarcinoma metastasis to the penis has variable presentation and potentially atypical histology that may require immunohistochemical, biomarker, and genetic analysis for confident diagnosis. Case Description: We present a 56-year-old patient with advanced prostate cancer post-chemoradiation and androgen deprivation therapy with an uncommon site… More >

  • Open Access

    ARTICLE

    Safety and outcomes of salvage HoLEP after TURP: a comparative study

    Volkan Sabur1,*, Abdullah Gölbaşı2
    Canadian Journal of Urology, DOI:10.32604/cju.2026.074330
    (This article belongs to the Special Issue: Prostatic Enucleation: Current Evidence and Contemporary Practice)
    Abstract Background: Recurrent prostate surgery may pose additional challenges for achieving an efficient and anatomically precise enucleation. This research investigates how prior transurethral resection of prostate (TURP) affects the perioperative course, functional outcomes, and technical difficulty of Holmium Laser Enucleation of the Prostate (HoLEP) when performed as a primary procedure versus as a salvage treatment. Methods: In this retrospective study, 174 patients who underwent HoLEP between August 2023 and April 2025 were analyzed. Group 1 included 137 patients undergoing primary HoLEP, and group 2 included 37 patients undergoing HoLEP for TURP recurrence. Outcomes assessed included enucleation… More >

  • Open Access

    CASE REPORT

    Beckwith–Wiedemann syndrome and medullary sponge kidney: a case report of two rare but related entities

    Alberto Zambudio-Munuera1, María del Carmen Cano-Garcia1,2, Africa Navarro-Garcia1, Jose Luis Martin-Rodriguez3,4, Miguel Angel Arrabal-Polo1,2,4,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.077945
    Abstract Background: Beckwith–Wiedemann syndrome (BWS) is a congenital overgrowth disorder that may be associated with renal abnormalities, although benign renal manifestations presenting in adulthood are less well characterized. Case description: We report the case of a 20-year-old woman with genetically confirmed BWS who was diagnosed with medullary sponge kidney (MSK) during adulthood after imaging evaluation for suspected renal abnormalities. Contrast-enhanced computed tomography and intravenous urography demonstrated characteristic medullary collecting duct dilatation with nephrocalcinosis, consistent with MSK, associated with hypercalciuria and hypocitraturia. Medical management with thiazide diuretics and potassium citrate achieved metabolic control and stable imaging findings. Conclusion: More >

  • Open Access

    ARTICLE

    Outcomes following surgical management of urinary stone disease in older patients

    Jonathan J. Song1, I-Chun (Jinn) Thomas2, Amber Herbert3, Calyani Ganesan2,3,4, Alan C. Pao2,3,4, Timothy Chang2,3, Ryan R. Sun3, John T Leppert2,3,4, Simon L Conti3,*
    Canadian Journal of Urology, DOI:10.32604/cju.2026.074683
    Abstract Background: The prevalence of urinary stone disease (USD) is increasing among older patients. Data examining the association between patient age and clinical outcomes following surgical treatment for USD are limited. Our objective was to assess the safety profiles of ureteroscopy (URS), extracorporeal shock wave lithotripsy (ESWL), and percutaneous nephrolithotomy (PCNL) for USD by age in an older patient population. Methods: We retrospectively identified all patients who underwent URS, ESWL, and PCNL for USD from 2010 to 2019 in the Veterans Health Administration. We fit multivariable logistic regression models to determine the association between age and… More >

  • Open Access

    ARTICLE

    Testicular prosthesis complications and satisfaction rates after gender affirming scrotoplasty

    Liliana Guadagni1, Marco Falcone2,3,4, Lorenzo Cirigliano2,5,*, Ilaria Ferro2, Mirko Preto2, Natalia Plamadeala2, Martina Scavone2, Emanuele Zupo2, Paolo Gontero2
    Canadian Journal of Urology, DOI:10.32604/cju.2026.076284
    Abstract Background: Testicular prosthesis implantation (TPI) is frequently performed as part of masculinizing genital gender-affirming surgery (GGAS), but complication and satisfaction data for assigned female at birth (AFAB) men remain limited. We report a single-centre experience assessing postoperative complications, explantation-free survival (EFS) and patient-reported satisfaction. Methods: We conducted a retrospective cohort study including all patients who underwent unilateral or bilateral transmasculine TPI (TM-TPI) from May 2007 to April 2025. Primary outcomes were postoperative complications (e.g., surgical-site infection, contamination, hematoma, migration, pain, extrusion) and EFS rate. Satisfaction was measured at 12 months using the 13-item Transmasculine Testicular… More >

  • Open Access

    HypnoVR® in minimally invasive surgical techniques (MISTs) for lower urinary tract symptoms (LUTS): a safe, sedation-reducing tool improving patient experience

    Alberto Olivero1,*, Sofia Giudici2, Alberto Caviglia1, Erika Palagonia1, Marco Nizzardo3, Alberto Quistini3, Andrea Grasso4, Ofir Maltzman1, Marco Colombo5, Stefano Tappero1, Elio Mazzone1, Paolo Dell’Oglio1, Aldo Massimo Bocciardi1, Antonio Galfano1, Silvia Secco1
    Canadian Journal of Urology, DOI:10.32604/cju.2026.076804
    (This article belongs to the Special Issue: Advances and Evolving Techniques in Functional Urology)
    Abstract Background: Minimally invasive surgical techniques (MISTs) are becoming an increasingly popular outpatient treatment option for lower urinary tract symptoms. Although generally well-tolerated, MISTs may cause periprocedural discomfort. Virtual reality devices (VRDs) have been shown to reduce patient-reported pain during several procedures. This study aims to evaluate whether the use of VRD during MISTs could improve perioperative endovenous sedation needs of a VRD during MISTs in a case-control design. Methods: We retrospectively analyzed patient data from MISTs performed between January 2024 and July 2025 at a single referral center (ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy).… More >

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