Background/Objectives: Catheter-related bladder discomfort (CRBD) commonly occurs in patients undergoing urologic surgery and significantly affects patient comfort and recovery. We evaluated the efficacy and safety of continuous local ropivacaine infusion using a specialized multi-porous urethral catheter in reducing postoperative CRBD. Methods: This multicenter, prospective, randomized, single-blind trial enrolled 136 male patients undergoing short-term catheterization after urologic surgery. Participants were randomized into three groups—a control group receiving saline infusion, Group 1 receiving 0.5% ropivacaine at 1 mL/h, and Group 2 receiving 0.5% ropivacaine at 2 mL/h—for up to 48 h via a multi-porous urethral catheter. The primary outcome was the incidence of CRBD at 24 h postoperatively. Secondary outcomes included changes in urethral pain assessed by a visual analog scale (VAS), urinary symptom scores, complication rates, and patient-reported catheter inconvenience and reuse intention using Likert scales. Results: The incidence of CRBD was significantly lower in Group 1 (19.6%) and Group 2 (11.1%) compared to the control group (44.4%; p = 0.001), demonstrating a clear dose–response relationship. Changes in urethral pain scores (VAS) from baseline were significantly lower in the ropivacaine groups compared to the control (p = 0.023). Complication rates were similar among groups (control 13.3%, Group 1 6.5%, Group 2 15.6%; p = 0.378), although catheter leakage occurred more frequently in Group 2, without statistical significance (p = 0.122). Conclusions: Continuous local ropivacaine infusion using a multi-porous urethral catheter effectively reduces the incidence of postoperative CRBD without increasing side effects. This approach may improve patient comfort during perioperative catheter management.

This study aimed to assess the incidence, severity, and onset of dermatologic adverse events (dAEs) in Korean patients treated with apalutamide for metastatic hormone-sensitive prostate cancer (mHSPC) and to identify clinical and laboratory predisposing factors. We retrospectively analyzed data of patients treated with apalutamide for mHSPC at a tertiary referral center in Korea between April 2023 and March 2024. Patients with a radical prostatectomy history or insufficient data were excluded. The onset, severity, and management of dAEs were evaluated and compared between patients with and without dAEs. Clinical and laboratory data from 1 month prior to apalutamide administration were collected. Logistic regression was performed to identify predictors of dAEs, and the predictive value of serum albumin levels was analyzed using the receiver operating characteristic (ROC) curve. Twenty-six (40.0%) of the 65 patients developed dAEs, including nine (13.8%) with Grade ≥3 events. The median onset of dAEs was 66.5 (45–78) days. Patients with dAEs had significantly lower initial prostate-specific antigen levels (70.4 vs. 301.6 ng/mL), higher Eastern Cooperative Oncology Group Performance Status (ECOG-PS; 30.8% vs. 5.1%), and lower serum albumin levels (3.8 vs. 4.1 g/dL). Logistic regression identified elevated Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) and hypoalbuminemia as significant predictors of dAEs. ROC analysis for serum albumin levels produced an area under the curve of 0.739, with a cutoff value of 3.85 g/dL, yielding a sensitivity and specificity of 65.4% and 74.4%, respectively. dAEs are prevalent in Korean patients treated with apalutamide for mHSPC, with ECOG-PS and serum albumin levels identified as significant risk factors.

Sang Hoon Song, Sangmin Lee, Kun Suk Kim. Theater Endourol. Robot. 2025;1:35-40. https://doi.org/10.64364/tier.25.0005

DNA methylation is one of the most extensively characterized epigenetic alterations in cancer and provides a biologically stable, analytically tractable foundation for biomarker development. In genitourinary (GU) oncology, the early occurrence, clonal maintenance, and chemical stability of aberrant cytosine-phosphate-guanine methylation enable reliable detection in tissue, urine, and plasma, supporting its use in liquid biopsybased diagnostics and surveillance. Recent advances have enabled clinical evaluation of DNA methylation assays across multiple GU malignancies. Among these, urothelial carcinoma has progressed furthest toward clinical translation: urine-based methylation tests have demonstrated high diagnostic accuracy and reproducibility and, in selected settings, have achieved regulatory approval or guideline incorporation for surveillance. In renal cell carcinoma, genome-wide plasma and urine methylome profiling has shown feasibility for early detection and prognostic stratification, although clinical implementation remains investigational. In prostate cancer, tissue-based methylation assays support repeat-biopsy decision-making, whereas urine- and plasma-based tests contribute to detection of clinically significant disease, molecular subtyping, and treatment-response monitoring. Despite strong analytical performance, broad clinical adoption of DNA methylation biomarkers remains constrained by limited prospective validation, interlaboratory variability, and incomplete evidence of cost-effectiveness in real-world care pathways. Economic modeling suggests that these assays could reduce invasive procedures and surveillance costs, but these findings require confirmation in prospective studies. Given the accessibility of urine as a noninvasive biospecimen and ongoing integration with machine-learning and multiomic frameworks, DNA methylation profiling is well positioned to complement conventional diagnostics and advance precision detection, surveillance, and prognostication in GU cancers.

Background: Robot-assisted laparoscopic ureteral reimplantation via an extravesical approach (RALUR-EV) is an established minimally invasive option for vesicoureteral reflux (VUR); however, surgical success remains variable, and detrusorraphy technique is a key determinant of reflux resolution. This study evaluated whether a refined detrusorraphy technique is associated with improved surgical outcomes following RALUR-EV. Methods: We retrospectively reviewed patients who underwent RALUR-EV performed by a single surgeon between August 2013 and February 2023. A technique modification introduced in November 2021 incorporated ureteral adventitia inclusion during detrusorraphy and a distal-first detrusorraphy suture. Patients were divided into two groups according to the surgical period. Surgical success was defined as radiographic resolution of VUR on postoperative voiding cystourethrography without ureteral obstruction. Results: A total of 62 patients (96 ureters) were included. The modified technique group demonstrated significantly higher surgical success rates than the conventional group at both the ureter level (97.8% vs. 76.5%, p = 0.002) and the patient level (96.6% vs. 69.7%, p = 0.006). On patient-level multivariable analysis, the modified detrusorraphy technique was independently associated with a reduced risk of surgical failure. Conclusions: A refined detrusorraphy technique is associated with improved early radiographic success after RALUR-EV without increasing perioperative morbidity.