The Journal of urology Impact Factor & Information

Publisher: American Urological Association, Elsevier

Journal description

The most widely read publication in the field, The Journal of Urology® brings solid coverage of all the clinically relevant information needed to stay at the forefront of this dynamic field. The Journal presents investigative studies on critical areas of research and practice; survey articles providing short condensations of the best and most important urology literature worldwide; and practice-oriented reports on interesting clinical observations.

Current impact factor: 3.75

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 3.753
2012 Impact Factor 3.696
2011 Impact Factor 3.746
2010 Impact Factor 3.862
2009 Impact Factor 4.016
2008 Impact Factor 3.952
2007 Impact Factor 4.053
2006 Impact Factor 3.956
2005 Impact Factor 3.592
2004 Impact Factor 3.713
2003 Impact Factor 3.297
2002 Impact Factor 3.03
2001 Impact Factor 3.19
2000 Impact Factor 2.896
1999 Impact Factor 2.486
1998 Impact Factor 2.685
1997 Impact Factor 2.719
1996 Impact Factor 2.668
1995 Impact Factor 2.792
1994 Impact Factor 2.539
1993 Impact Factor 2.231
1992 Impact Factor 1.91

Impact factor over time

Impact factor
Year

Additional details

5-year impact 4.02
Cited half-life 7.90
Immediacy index 0.63
Eigenfactor 0.09
Article influence 1.04
Website Journal of Urology, The website
Other titles Journal of urology (Online), The journal of urology
ISSN 1527-3792
OCLC 42747133
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Elsevier

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, arXiv.org or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • Thomas F Kolon
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    ABSTRACT: Varicocele is one the most common genital issues referred to pediatric urologists. Most adolescents with a varicocele are asymptomatic and their fertility future (and surgery benefit) is largely unknown. This review assesses varicocele evaluation, management and indications for repair, as well as types and success of varicocelectomy. A systematic literature review was performed on Embase™, PubMed®, and Google Scholar™ for adolescent varicocele. Original research articles and relevant reviews were examined and a synopsis of these data was generated for a comprehensive review of clinical adolescent varicocele management. The prevalence of adolescent varicocele is similar to the adult population. While ultrasound is the most sensitive method for determining testicular volumes, orchidometer measurement may be adequate to gauge significant discordance. Significant hypotrophy of the affected testis with poor total testicular volume may indicate a testis at risk and warrant surgical repair. Similar findings have also been noted with an associated high peak retrograde venous flow. Testicular hypotrophy often resolves after surgery but may also improve spontaneously if followed through adolescence. Continued scrotal pain despite adequate support or serial abnormal semen analyses in Tanner 5 boys are indications for varicocelectomy. Artery- and lymphatic-sparing techniques (microscopic subinguinal or laparoscopic) are associated with the lowest risk of recurrence and complication. Overtreatment and undertreatment are medically and financially costly. Abnormal serial semen analyses with or without testicular hypotrophy is an indication for varicocele repair. If observation remains the treatment, follow-up with an adult urologist should be encouraged until paternity is achieved. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.079
  • C N Silva, K P Nunes, F S Torres, J S Cassoli, D M Santos, F M Almeida, A Matavel, J S Cruz, A Santos-Miranda, A D C Nunes, [...], C D Chávez-Olórtegui, S S Láuar, L Felicori, J M Resende, E R Camargos, M H Borges, M N Cordeiro, S Peigneur, J Tytgat, M E De Lima
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    ABSTRACT: We designed a peptide, PnPP-19, comprising the potential active core of Phoneutria nigriventer native toxin PnTx2-6, and investigated its role on EF, its toxicity and immunogenicity. EF was evaluated through ICP/MAP ratio during EFS on rat pelvic ganglion. Corpus cavernous strips were PE-contracted and relaxation was induced by EFS with or without PnPP-19 (10(-8)M). The activity on sodium channels was evaluated by electrophysiological screening of transfected channels on Xenopus oocytes and DRG cells. Antibodies were detected by indirect ELISA in mice previously treated with the peptide. Histopathological studies were performed with mice organs receiving different doses of PnPP-19. PnPP-19 was able to potentiate erection at 4 and 8 Hz, in vivo and ex vivo. It showed no toxicity and low immunogenicity to mice and did not affect sodium channels or rat hearts. PnPP-19 increased cGMP levels at 8 Hz and this effect was inhibited by L-NAME (10(-4)M). EF was partially inhibited by 7-nitroindazole (7-NI, 10(-5)M), a selective inhibitor of nNOS. PnPP-19 potentiates erection, in vivo and ex vivo, via NO/cGMP pathway, does not affect sodium channels or rat heart, and shows no toxicity and low immunogenicity, what makes it a very promising candidate as a novel drug in the therapy of erectile dysfunction. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.081
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    ABSTRACT: Neoadjuvant chemotherapy before cystectomy is recommended. The subset of patients likely to benefit has not been identified. Our aim was to validate emmprin and survivin as markers of chemotherapy response. Tumor specimens were obtained before therapy from 250 patients with T1-T4 bladder cancer enrolled in two randomized trials comparing neoadjuvant chemotherapy before cystectomy with a surgery only arm. Protein expression was determined with immunohistochemistry. Expression was categorized according to predefined cutoffs reported in the literature. The data were analyzed with the Kaplan-Meier method and Cox models. Patients in the chemotherapy cohort with negative emmprin expression had a significantly higher downstaging overall survival (OS) compared to those with positive expression, 71 % versus 38 %, p<0.001. The corresponding figures for cancer-specific survival (CSS) were 76 % and 56 %, p< 0.027. In the cystectomy only cohort, emmprin expression was not associated with either OS (46 % and 35 %, p=0.23) or CSS (55 % and 51 %, p=0.64). The emmprin negative patients had an absolute risk reduction of 25% in overall survival (CI 11-40) and a number needed to treat (NNT) of 4 (CI 2.5-9.3). Survivin expression was not useful as biomarkers in this study. The limitations are the retrospective design and heterogeneity coupled with the time difference between the trials. Patients with emmprin negative tumors have a better response to neoadjuvant chemotherapy before cystectomy than those with positive expression. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.085
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    ABSTRACT: PURPOSE: We designed a peptide, PnPP-19, comprising the potential active core of Phoneutria nigriventer native toxin PnTx2-6, and investigated its role on EF, its toxicity and immunogenicity. MATERIAL AND METHODS: EF was evaluated through ICP/MAP ratio during EFS on rat pelvic ganglion. Corpus cavernous strips were PE-contracted and relaxation was induced by EFS with or without PnPP-19 (10-8M). The activity on sodium channels was evaluated by electrophysiological screening of transfected channels on Xenopus oocytes and DRG cells. Antibodies were detected by indirect ELISA in mice previously treated with the peptide. Histopathological studies were performed with mice organs receiving different doses of PnPP-19. RESULTS: PnPP-19 was able to potentiate erection at 4 and 8 Hz, in vivo and ex vivo. It showed no toxicity and low immunogenicity to mice and did not affect sodium channels or rat hearts. PnPP-19 increased cGMP levels at 8 Hz and this effect was inhibited by L-NAME (10-4M). EF was partially inhibited by 7-nitroindazole (7-NI, 10-5M), a selective inhibitor of nNOS. CONCLUSIONS: PnPP-19 potentiates erection, in vivo and ex vivo, via NO/cGMP pathway, does not affect sodium channels or rat heart, and shows no toxicity and low immunogenicity, what makes it a very promising candidate as a novel drug in the therapy of erectile dysfunction. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.081.
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    ABSTRACT: Active surveillance is increasingly recommended for older men with low-risk prostate cancer. Although older men have higher all-cause mortality, they also have higher prostate cancer-specific mortality. We hypothesized that older age is associated with an increased risk of Gleason score upgrading at confirmatory biopsy when controlling for prostate volume. We retrospectively reviewed data from 1,130 patients with prostate cancer who were treated with AS from 1991 through 2011. We included 646 patients who had clinical Gleason ≤6 stage ≤T2a prostate cancer, a confirmatory biopsy within 2 years of diagnostic biopsy, and prostate MRI prior to the confirmatory biopsy. The primary outcome was Gleason score upgrading to ≥7 on confirmatory biopsy. We used logistic regression to estimate the effect of age on upgrading, adjusting for MRI prostate volume and other potential confounders. Median age was 66 years (IQR 61-72) and MRI prostate volume was 41 mL (IQR 29-55). At confirmatory biopsy, 9% (55/646) of patients were upgraded, 45% (290/646) were unchanged, and 46% (297/646) had a negative biopsy. Older age was associated with higher odds of being upgraded (adjusted OR 1.05, 95% CI 1.01-1.09; p=0.009), and larger prostate volume was associated with lower odds of being upgraded (adjusted OR 0.80 per 10mL increase, 95% CI 0.7-0.9; p=0.012). Our findings suggest that older age is associated with an increased risk of misclassification on diagnostic biopsy. Older men who are interested in AS should be counseled about the risks and benefits of having a confirmatory biopsy. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.084
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    ABSTRACT: MRI-ultrasound fusion-targeted prostate biopsy (MRF-TB) may improve detection of prostate cancer (PCa) in men presenting for prostate biopsy. We report clinical outcomes of 12-core systematic biopsy (SB) and MRF-TB in men presenting for primary biopsy and further describe pathological characteristics of cancers detected by SB and not by MRF-TB. Clinical outcomes of 435 consecutive men who underwent pre-biopsy mpMRI followed by MRF-TB and SB at our institution between June 2012 and March 2015 were captured in an IRB-approved database Clinical characteristics, biopsy results and MRI suspicion scores (mSS) were queried from the database. Among 370 men (mean age 64±8.5 years; mean PSA 6.8, SEM 0.3 ng/mL) who met inclusion criteria, PCa was detected in 200 (54.1%) cases. Cancer detection rates for SB and MRF-TB were 47.3% and 43.5%, respectively (p = 0.104). MRF-TB detected more Gleason score ≥7 cancers than SB (114/128 (89.1%) vs 95/128 (74.2%), respectively, p = 0.008). Of 39 cancers detected by SB, but not by MRF-TB, 32/39 (82.1%) demonstrated Gleason 6 disease, and 24/39 (61.5%) and 32/39 (82.1%) were clinically insignificant by Epstein and UCSF CAPRA (score ≤ 2) criteria, respectively. In men presenting for primary prostate biopsy, MRF-TB detects more high grade cancers than SB. Most cancers detected by SB, and not by MRF-TB, are clinically low-risk. Pre-biopsy MRI followed by MRF-TB reduces detection of low-risk cancers while significantly improving detection and risk-stratification of high-grade disease. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.078
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    ABSTRACT: Information on patterns of lymph node metastases (LNM) for upper tract urothelial carcinoma (UTUC) is sparse. We investigate patterns of LNM in UTUC. Retrospective multi-institutional study of 73 patients with N+M0 UTUC undergoing template lymphadenectomy during nephroureterectomy. Anatomic locations of tumor, number of lymph nodes removed, positive lymph nodes were analyzed and descriptive statistics performed. On right side: renal pelvis tumors (n=20) had LNM to the hilum (22.1%), paracaval (44.1%), retrocaval (10.3%) and interaortocaval (20.6%) regions. Proximal ureter tumors (n=10) had LNM to hilum (46.2%), paracaval (46.2%), and retrocaval (7.7%) regions. Distal ureter tumors (n=2) had LNM equally to paracaval and pelvic regions. On left side: patients with renal pelvis tumors (n=24) had LNM to hilar (50.0%), and paraaortic (30.0%) regions. Proximal ureter tumors (n=8) had LNM to hilar (36.4%) and paraaortic (63.6%) regions. Mid ureter tumors (n=5) had LNM to paraaortic (40%), common iliac (40%) and internal iliac (20%) regions. Distal ureter tumors (n=4) had LNM to paraaortic (33.3%), common iliac (33.3%), and external and internal iliac (16.7% each). Interaortocaval involvement from both sides as well as out-of-field LNM appeared to occur secondarily. Consolidated templates were constructed based on the available data. UTUC has characteristic patterns of LNM dependent on the side and anatomic location of the primary tumor, including right to left migration and involvement of interaortocaval nodes in the setting of proximal disease. Standardized dissection templates should be prospectively evaluated in multi-center trials to assess for morbidity and potential clinical benefit. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.077
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    ABSTRACT: to describe the indications, technique and outcome of transrenal antegrade ureteral occlusion. An institutional database was used to retrospectively identify patients who underwent image-guided transrenal ureteral occlusion between December 1998 and March 2014. Platinum coils were deployed into the distal ureter or 4-5 cm proximal to the site of ureteric leak. Gelfoam pledgets were injected to the ureter at the level of the coils. Additional coils were deployed to trap the Gelfoam in the distal ureter. Between December 1998 and March 2014, 24 patients (12 men, 12 women; age range 45-87 years, mean age 69 years) underwent fluoroscopically guided transrenal antegrade ureteral occlusion for intractable hematuria (n = 7), urinary fistula (n = 17). In total, 39 ureteric units were occluded (right, n=3; left, n=6; bilateral, n=30). Ureteric occlusion was successful in 35/37 (94.6 %) ureteric units, determined by post-procedure antegrade nephrostogram and resolution of clinical symptoms of hematuria and/or urinary leakage. Repeat occlusion was necessary to achieve total ureteric occlusion for 2/35 (5.7%) ureteric units. percutaneous ureteric occlusion with platinum coils and gelfoam offers a treatment option for patients with refractory urinary fistula, intractable hematuria for whom standard methods of urinary diversion fail. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.02.2964
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    ABSTRACT: Diabetes mellitus type II (T2DM) is considered an important risk factor for urinary incontinence. We investigated associations among biochemical measures of diabetes with stress and urgency urinary incontinence (SUI, UUI) in a nationally representative sample of U.S. women. We performed a cross-sectional analysis of female adult participants in the 2001-2010 National Health and Nutrition Examination Survey (NHANES). Urinary incontinence was ascertained by self-report. Diabetes was defined by calculated measures of glycemic control and insulin resistance. Glycemic control was classified by hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG). Insulin resistance was estimated by fasting plasma insulin (FPI) and the homeostasis model assessment of insulin resistance (HOMA-IR) definition. Logistic regression models, adjusted for socio-demographic variables and risk factors were fitted for each measure of T2DM severity and presence of SUI and UUI. Stepwise multivariable logistic regression models were developed to characterize independent risk factors for SUI and UUI. Compared with women with a normal HbA1c, participants with T2DM had an increased prevalence of both SUI (38.6% vs. 52.5%, p<0.001) and UUI (21.7% vs. 40.3%, p<0.001). T2DM measures were each significantly associated with UI in unadjusted models. However, they were not independently associated with SUI or UUI in multivariable models when adjusted for patient body mass index (BMI). Despite an increased prevalence of SUI and UUI among women with diabetes, measures of T2DM are not independently associated with female incontinence. Rather, BMI and several other characteristics are the dominant risk factors for either SUI or UUI. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.074
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    ABSTRACT: In October 2011, the United States Preventive Services Task Force (USPSTF) issued a draft guideline, discouraging the use of prostate-specific antigen (PSA) based screening for prostate cancer (grade D recommendation). Our objective was to evaluate the effect of the USPSTF guideline on the number and distribution of new prostate cancer diagnoses in the US. We identified incident cancers diagnosed between January 2010 and December 2012 in the National Cancer Database. We performed an interrupted time series to evaluate the trend of new prostate cancers diagnosed each month before and after the draft guideline, with colon cancer as a comparator. Incident monthly prostate cancer diagnoses dropped by -1363 cases (12.2%, p<0.01) in the month after the USPSTF draft guideline and continued to decrease by 164 cases per month relative to baseline (-1.8%; p<0.01). By contrast, monthly colon cancer diagnoses remained stable. Diagnoses of low, intermediate, and high-risk prostate cancers decreased significantly, but new diagnoses of non-localized disease did not change. Subgroups of age, comorbidity, race, income, and insurance all experienced comparable decreases in incident prostate cancer following the draft guideline. There was a 28% decline in incident diagnoses of prostate cancer in the year following the USPSTF draft recommendation against PSA screening. This study helps quantify the potential benefits (reduced harms of overdiagnosis and overtreatment of low risk disease and disease found in elderly men) and potential harms (missed opportunities to diagnose important cancers in men who may benefit from treatment) of this guideline. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.075
  • The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.071
  • The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.069
  • The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.070
  • The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.033
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    ABSTRACT: - To evaluate the efficacy and tolerability of the nicotinic channel modulator, dexmecamylamine, in overactive bladder MATERIALS AND METHODS: - This was a, randomized, double-blind, placebo controlled trial in 768 randomized subjects. Subjects with at least a 6-month history of overactive bladder were randomized to 0.5, 1.0mg, 2mg dexmecamylamine or placebo in a ratio of 1:1:1:2, respectively. Subjects completed a 3-day diary before each visit associated with the 12 week treatment period. Subjects were required to have ≥8 micturitions/day and ≥3 urinary urge incontinent episodes/day, if OAB wet, at the end of a placebo run-in period. Co-primary endpoints for the study included (i) change from baseline in micturition frequency/24 hours at Week 12 and (ii) change from baseline in UUI episodes/24 hours at Week 12. Secondary endpoints were volume voided, nocturia episodes, OABq, and Urgency Questionnaire. -2mg dexmecamylamine produced a statistically significant decrease in micturition frequency (p = 0.03) but did not produce a statistically significant decrease in urge incontinence (wet) episodes (p = 0.38). Secondary endpoints including volume voided (in 1 mg group only), CGI-I, the VAS urgency impact, intensity and impact were statistically significant at Week 12 for the 2 mg dose. Dexmecamylamine was well tolerated in this subject population with a low incidence of discontinuations due to AEs. Constipation, dry mouth, and urinary tract infection showed a dose-dependent increase in frequency. - DEX does not appear to offer an enhanced therapeutic profile in the treatment of OAB relative to current therapies. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.035
  • The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.02.2961
  • The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.06.020
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    ABSTRACT: Increasing evidence has shown that protein tyrosine phosphatases play dominant roles in setting the levels of tyrosine phosphorylation and promote oncogenic processes. Protein tyrosine phosphatase type IVA 3 (PTP4A3) has been implicated in cancer metastasis, however the role of PTP4A3 in upper tract urothelial carcinoma (UTUC) is unknown. The aim of this study was to investigate the association of PTP4A3 with disease characteristics, distant metastasis, and prognosis of UTUC. The importance of PTP4A3 was initially examined in paired normal urothelium, non-invasive UTUC, invasive UTUC, and nodal metastatic tissue. The PTP4A3 transcript level was assessed in another 20 UTUC samples by real-time RT-PCR. PTP4A3 protein expression was determined by immunohistochemistry (H-score) in 340 UTUC samples, and further correlated with clinicopathological factors, disease-specific survival and metastasis-free survival. The expression of PTP4A3 significantly increased from normal urothelium, non-invasive UTUC, invasive UTUC, to nodal metastatic tissue (p <0.001). The PTP4A3 transcript level was also markedly upregulated in higher stage UTUC (p = 0.002). The overexpression of PTP4A3 protein was significantly associated with advanced pT status, nodal metastasis, lymphovascular invasion, and perineural invasion (all p <0.001), and an inferior disease-specific survival and metastasis-free survival in multivariate analysis (both p <0.0001). In addition, it predicted metastasis in patients with pTa, pT1, and pT2 UTUC. The results imply that PTP4A3 plays a role in the carcinogenesis of UTUC. PTP4A3 overexpression independently predicted metastasis and outcome of UTUC, which was even more important in organ-confined disease. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.05.101
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    ABSTRACT: Although chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological disorder among men of all ages, its etiology remains unknown. Only a few previous studies have examined associations between lifestyle factors and CP/CPPS, most of which were limited by their cross-sectional study design and lack of control for possible confounders. To address these limitations, we performed a cohort study of major lifestyle factors (obesity, smoking, and hypertension) with CP/CPPS risk in the Health Professionals Follow-up Study (HPFS), a large ongoing cohort of US-based male health professionals. The HPFS includes 51,529 men aged 40-75 years at baseline in 1986. At enrollment and every two years thereafter, participants have completed questionnaires on lifestyle and health conditions. In 2008, participants completed an additional set of questions on recent CP/CPPS pain symptoms modified from the NIH Chronic Prostatitis Symptom Index (NIH-CPSI), as well as questions on approximate date of symptom onset. Participants with NIH-CPSI pain scores ≥8 who first experienced symptoms after 1986 were considered incident CP/CPPS cases (n=653) and those who completed CP/CPPS questions but did not report CP/CPPS-related pain were considered non-cases (n=19,138). No associations were observed for baseline body mass index, waist circumference, waist-to-hip ratio, cigarette smoking, and hypertension with CP/CPPS risk (all odds ratios ≤1.34). In this large cohort study, none of the lifestyle factors examined was associated with CP/CPPS risk. As the etiology of CP/CPPS remains unknown, additional prospective studies are needed to elucidate modifiable risk factors for this common condition. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.05.100
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    ABSTRACT: No population-based studies have examined whether long-term exposure to testosterone therapy is associated with an increased risk of high-grade prostate cancer. In this study, we examined whether exposure to testosterone over a 5-year period was associated with an increased risk of high-grade prostate cancer and whether this risk increased in a dose-response fashion with cumulative number of testosterone injections. Using SEER-Medicare linked data, we identified 52,579 men who were diagnosed with incident prostate cancer between January 1, 2001 and December 31, 2006 and who had a minimum of 5 years continuous enrollment in Medicare before their cancer diagnosis. We excluded patients who were diagnosed at death or after autopsy, enrolled in a health maintenance organization in the 60 months before diagnosis, or had unknown tumor grade or tumor stage. In the 5 years before their diagnosis, 574 men had a history of testosterone use and 51,945 did not. Using logistic regression adjusting for demographic and clinical characteristics, exposure to testosterone therapy was not associated with an increased risk of high-grade prostate cancer (OR 0.84, 95% CI 0.67-1.05) or receipt of primary ADT following diagnosis (OR 0.97, 95% CI 0.74-1.30). In addition, the risk of high-grade disease did not increase according to total number of testosterone injections (OR 1.00, 95% CI 0.98-1.01). Our finding that testosterone therapy was not associated with an increased risk of high-grade prostate cancer may provide important information regarding the risk-benefit assessment for men with testosterone deficiency considering treatment. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of urology 06/2015; DOI:10.1016/j.juro.2015.05.099