INTRODUCTION: The aim of this narrative review is to evaluate the uretero-ureteral anastomosis (UUA) methods applied as a surgical option in duplicated renal systems. MATERIAL AND METHODS: Studies evaluating pediatric pa...INTRODUCTION: The aim of this narrative review is to evaluate the uretero-ureteral anastomosis (UUA) methods applied as a surgical option in duplicated renal systems. MATERIAL AND METHODS: Studies evaluating pediatric patients under 18 years of age who underwent any type of uretero-ureteral anastomosis due to double collecting system were included in the review. The other surgical methods to treat duplex systems such as heminephrectomy, ureteral reimplantation and ureteral clipping were excluded. The studies found by searching the keywords «double collecting system ureter ureteral anastomosis», «double collecting system ureteroureterostomy», «duplex kidney ureter ureteral anastomosis», «duplex kidney ureteroureterostomy» in PubMed. Study design, operative measures, technique of surgery, follow-up time, key results and complications were recorded. RESULTS: A total of 29 studies from 1967 to 2024 (including 2024) were included in the review. When the studies were analysed, there were no studies comparing the three main UUA procedures (open, laparoscopic and robot-assisted laparoscopic). In studies comparing open and robot-assisted UUA, and laparoscopic versus open techniques, minimally invasive approaches demonstrated shorter hospital stays and comparable outcomes, while operation times were similar across groups. DISCUSSION: According to the available literature, all of the operative approaches are feasible with high success and low complication rates. However, it is not sufficient to determine the superiority of open, laparoscopic and robot-assisted laparoscopic UUA methods. Prospective comparative studies are required to elucidate the effectivity of different methods to treat duplex systems in children.
INTRODUCTION: Vesicoureteral reflux (VUR) may have long lasting effects on affected individuals, especially in females. Its intertwined relationship with urinary tract infection (UTI) has been well documented and there i...INTRODUCTION: Vesicoureteral reflux (VUR) may have long lasting effects on affected individuals, especially in females. Its intertwined relationship with urinary tract infection (UTI) has been well documented and there is a further risk during pregnancy where UTIs are more problematic. OBJECTIVE: To analyze existing data within the literature to identify factors associated with pregnancy-related complications in women with a history of VUR in childhood. METHODS: PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched to identify all published reports of pregnancy outcomes in women with a history of VUR in childhood up to January 2024 (PROSPERO Registration ID: CRD42024550470). Selection criteria included all English-language original articles reporting pregnancy outcomes (maternal and fetal morbidities) in pregnant patients with a history of VUR in childhood. After screening and eligibility assessment, 17 articles met the PICO inclusion criteria. RESULTS: The search yielded 1060 papers, of which 17 remained after exclusions, and assessed 2349 women with a history of VUR in childhood,1167 pregnant women and a total of 2206 pregnancies. Compared with the general obstetric population, the results showed an increased rate of pregnancy-related complications (particularly febrile urinary tract infection, gestational hypertension, pre-eclampsia) in the presence of renal scarring, even if the women had undergone anti-reflux surgery in childhood, but not persistent low-grade VUR. CONCLUSION: Despite the lack of larger prospective randomized controlled trials with long-term follow-up, based on the findings of this systematic review, we conclude that close monitoring during pregnancy should be recommended in the presence of persistent high-grade VUR or in women with renal scarring, even if VUR has resolved.
INTRODUCTION AND OBJECTIVES: Urolithiasis is a prevalent urological condition that requires continuous monitoring and management to prevent recurrence. The myLit-Control® App is a digital health tool designed to support...INTRODUCTION AND OBJECTIVES: Urolithiasis is a prevalent urological condition that requires continuous monitoring and management to prevent recurrence. The myLit-Control® App is a digital health tool designed to support self-management by tracking urinary pH, water intake, and medication adherence. This study aimed to describe the demographic and clinical characteristics of myLit-Control® App users in Spain, analyze their engagement patterns, and evaluate adherence to health goals. PATIENTS AND METHODS: This retrospective observational study included users who downloaded the app between May 2022 and June 2024. Data on demographics, urinary pH tracking, water intake, and medication adherence were extracted and analyzed to explore correlations, group comparisons, and identify factors influencing adherence and outcomes. RESULTS: The study included 699 users, with a median age of 50 years (IQR 40-59) and 57.1% male. A total of 217 users (31.0%) were taking urolithiasis-specific treatment. Urine pH monitoring was used by 52.9% of participants, with a rate of 53% (± 37) within target pH levels. Water intake tracking was the most frequently used feature, yet adherence to hydration goals remained low (15±30%). A negative correlation was observed between age and treatment adherence (r=-0.456, p<0.001). CONCLUSIONS: The myLit-Control® App facilitates urinary pH monitoring and medication adherence, supporting self-management in urolithiasis patients. However, engagement with key features, particularly water intake tracking, remains suboptimal. Future research should explore long-term outcomes and strategies to enhance patient adherence, ensuring effective integration of mHealth tools in routine clinical practice.
Juste-Alvarez S, García-Rayo Encina C, Gómez Del Cañizo C
… +4 more, Hernandez-Arroyo M, Miranda-Utrera NR, Rodriguez-Antolin A, Guerrero-Ramos Félix F
INTRODUCTION: Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival...INTRODUCTION: Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival rates between these two groups. This study aims to identify differences in recurrence and survival that may influence individualized treatment approaches. MATERIAL AND METHODS: Prospective study of cystectomies performed for MIBC between 2011 and 2023, collecting demographic, diagnostic, treatment, and recurrence data (local, urothelial, or distant). A comparative and multivariate analysis was conducted. RESULTS: We did not observe significant differences in recurrence rates between primary and progressive MIBC. However, the group with progression showed better overall survival (OS) rates at 2, 5 and 10 years (100%, 90%, 55%) compared to the primary (80%, 55%, 35%; p = 0.012), as well as better cancer-specific survival (CSS) (100%, 100%, 95% vs. 85%, 77%, 65%; p = 0.033). Independent risk factors for recurrence include pN+ (OR: 3.72) and lymphovascular invasion (LVI) (OR: 5.53). Predictors of lower OS include age, nodal involvement, LVI and relapse at any level. For CSS, predictors include nodal involvement, LVI and relapse at any level. CONCLUSIONS: In our series, patients with progressive MIBC have better OS and CSS. For both groups, pN + and LVI are independent risk factors for recurrence. Nodal involvement, LVI and relapse at any level are predictors of poorer OS and CSS.
OBJECTIVE: This study compares the clinical outcomes of Holmium:YAG (Ho:YAG) laser lithotripsy and Thulium Fiber Laser (TFL) lithotripsy in retrograde intrarenal surgery (RIRS) for kidney stones <20 mm. MATERIALS AND MET...OBJECTIVE: This study compares the clinical outcomes of Holmium:YAG (Ho:YAG) laser lithotripsy and Thulium Fiber Laser (TFL) lithotripsy in retrograde intrarenal surgery (RIRS) for kidney stones <20 mm. MATERIALS AND METHODS: Patients who underwent RIRS for renal stones <20 mm between September 2022 and November 2023 were prospectively analyzed. They were randomly assigned to either the TFL or Ho:YAG laser group using a sealed-envelope method. Preoperative demographics, stone characteristics, kidney-ureter-bladder x-ray (KUB), ultrasound and noncontrast computer tomography (NCCT) scan findings were recorded. Operative time, laser usage time, postoperative stone-free rate (SFR), and complications were assessed and statistically analyzed. RESULTS: A total of 126 patients (mean age: 49.16 ± 15.18 years; 64.3% male, 35.7% female) were included. The TFL group (n = 64, 50.8%) had significantly shorter operative and laser usage times than the Ho:YAG laser group (n = 62, 49.2%) (operative time: 45.77 ± 15.67 min vs. 52.79 ± 18.11 min, p = 0.031; laser usage: 29.84 ± 13.32 min vs. 36.39 ± 15.75 min, p = 0.024). No significant SFR difference was found between groups (TFL group: n = 57, 91.8% vs. Ho:YAG laser group: n = 60, 93.8% ; p = 0.488). CONCLUSION: In the treatment of kidney stones smaller than 20 mm using laser lithotripsy, both TFL and Ho:YAG laser are effective, safe, and associated with low complication rates. However, the use of TFL significantly reduces operative time and lithotripsy time, potentially improving surgical efficiency. Further studies with larger patient cohorts are necessary to validate these findings and provide additional insights into the advantages and limitations of each laser type.
INTRODUCTION: Renal cell carcinoma, ranked 14th in global incidence, is more common in men. Its incidence rates increase with age, peaking in individuals older than 75 years. The classic triad is present in only 17% of c...INTRODUCTION: Renal cell carcinoma, ranked 14th in global incidence, is more common in men. Its incidence rates increase with age, peaking in individuals older than 75 years. The classic triad is present in only 17% of cases. Surgical management involves total or partial nephrectomy, both associated with potential complications. OBJECTIVE: To identify the clinical profile and risk factors in patients with renal cell carcinoma. METHODOLOGY: An observational, cross-sectional, and analytical study was conducted on patients with renal cell carcinoma treated surgically in the Urology Department from January 2020 to June 2023. Demographic and clinical characteristics were analyzed in relation to TNM staging, histologic subtype, and morbidity and mortality. RESULTS: Among 83 patients, 48 (57%) were men, with a mean age of 59.2 years (SD 10.5). Hypertension (HTN) and obesity were the most frequent comorbidities, each affecting 37 patients (44.6%). Flank pain (37 patients, 44.6%) and hematuria (23 patients, 27.7%) were the most common manifestations. Age >50 years was associated with advanced stages (p = 0.003, OR 5.744, 95% CI 1.698-19.424), while obesity was associated with a lower risk of advanced stages (p = 0.0042, OR 0.220, 95% CI 0.075-0.648). Complications of open nephrectomy included bleeding in 26 patients (38.8%) and organ injury in 2 patients (2.9%). Mortality was reported in 1 patient. CONCLUSION: Age >50 years is a risk factor for advanced stages, while obesity is associated with a lower risk. Hematuria and flank pain were common, whereas abdominal mass was rarely reported.
INTRODUCTION: Stereotactic body radiation therapy (SBRT) has emerged as an effective option for the treatment of localized prostate cancer; however, data from real-world clinical practice remain limited. MATERIAL AND MET...INTRODUCTION: Stereotactic body radiation therapy (SBRT) has emerged as an effective option for the treatment of localized prostate cancer; however, data from real-world clinical practice remain limited. MATERIAL AND METHODS: Between January 2020 and December 2023, 251 patients with localized prostate cancer treated with SBRT were included in 12 centers in Spain. The treatment volume included prostate ± seminal vesicles, without prophylactic pelvic radiotherapy. A dose of 35-40 Gy was prescribed in 5 fractions, every other day. Acute genitourinary (GU), gastrointestinal (GI) and sexual toxicity was assessed up to 6 months post-treatment using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. RESULTS: A total of 251 patients were classified based on the National Comprehensive Cancer Network (NCCN®) classification. Four percent of patients had very low-risk disease, 26.3% low-risk, and 66.5% intermediate-risk (27.1% favorable intermediate and 39.4% unfavorable intermediate). Additionally, 2.8% were classified as high-risk and 0.4% as very high-risk. The median patient age was 72 years (range: 65-76), and the baseline PSA was 6.7 ng/ml (range: 5.3-8.7). The median SBRT dose was 40 Gy (range: 35-40 Gy). Grade 2 acute GU toxicity occurred in 6.4% of patients, and grade 3 in 0.4%. Grade 2 GI toxicity was observed in 0.8%, with no cases of grade 3 GI toxicity. Regarding sexual toxicity, 11.2% of patients experienced grade 2, and 1.2% grade 3 toxicity. CONCLUSIONS: Five-fraction SBRT is a feasible and safe treatment with a low incidence of acute toxicity.
OBJECTIVE: To assess the composition of urinary stones in Lanzhou area and provide a reference basis for its clinical prevention and treatment. METHODS: A total of 1284 patients with urinary stones were included in the s...OBJECTIVE: To assess the composition of urinary stones in Lanzhou area and provide a reference basis for its clinical prevention and treatment. METHODS: A total of 1284 patients with urinary stones were included in the study. The differences in the distribution of stone components among different genders and ages were then analyzed. RESULTS: The overall male-to-female ratio of the cases was 3.2:1. The average age of the patients was 45.1 ± 14.0 years old. The ratio between upper and lower urinary tract stones was 7.13:1. Mixed stone composition accounted for the majority, 79.0% (1014/1284), with calcium oxalate monohydrate + calcium oxalate dihydrate + carbonate apatite being the most prevalent at 35% (449/1284), and calcium oxalate monohydrate stones being the most prevalent of the single components at 17.8% (228/1284). Apatite carbonate 62.2% (191/307) and magnesium ammonium phosphate hexahydrate 9.8% (30/307) were significantly higher in female patients compared to apatite carbonate 55.2% (539/977) and 2.8% (27/977) in male patients. Calcium oxalate was significantly more prevalent in patients aged 18-60 years than in patients <18 and ≥60 years. The proportion of patients over the age of 60 with urinary stones (10.4%) was significantly higher than patients in other age groups. CONCLUSION: Urological stones in Lanzhou area are mainly of mixed type, calcium oxalate monohydrate + calcium oxalate dihydrate + carbonate apatite is the most; with the increase of patient's age, the proportion of uric acid stones increases; the distribution of urinary stone components has significant differences with different genders of patients and different age groups, which is of great significance for clinical prevention and treatment.
INTRODUCTION: Congenital renal and urogenital anomalies represent a major part of all congenital anomalies. These range from mild, transient conditions to severe forms leading to irreversible organ damage or perinatal mo...INTRODUCTION: Congenital renal and urogenital anomalies represent a major part of all congenital anomalies. These range from mild, transient conditions to severe forms leading to irreversible organ damage or perinatal mortality. Timely prenatal identification is crucial for expecting parents and their healthcare providers to decide about the continuation of a pregnancy or for careful planning of perinatal and postnatal care. OBJECTIVE: To describe the most common indications for referral of fetal renal and urogenital malformations, the process of narrowing the differential diagnosis based on prenatal ultrasonography and the coordination between prenatal and postnatal care in a tertiary care center in the Netherlands. RESULTS: The most common indications for referral of fetal renal and urogenital malformations are (1) Abnormal Renal Parenchyma, (2) Urinary Tract Dilatation, (3) Abnormal Bladder Appearance, and (4) Atypical Genitalia. In the differential diagnosis, ultrasonographic evaluation is crucial to determine the specific region of the urogenital system affected, its onset during pregnancy, and its progression throughout gestation. Integrated prenatal and postnatal care for these types of malformations relies on a multidisciplinary approach to guide parental decision-making in continuation of the pregnancy and optimize outcomes. Some cases only require routine perinatal care in secondary care centers, while complex malformations benefit from specialized planning at tertiary centers to improve outcomes. CONCLUSION: Dedicated ultrasonographic evaluation of fetal renal and urogenital anomalies in a tertiary care center enables accurate diagnosis and individualized care planning, particularly in complex cases. This approach provides parents with timely information, supports decision-making, and guides individualized perinatal care.
INTRODUCTION: Hypospadias surgery has a failure rate ranging from 10% for distal cases to over 30% for proximal cases. However, real-world outcomes may be worse, as some complications emerge late in puberty or are underr...INTRODUCTION: Hypospadias surgery has a failure rate ranging from 10% for distal cases to over 30% for proximal cases. However, real-world outcomes may be worse, as some complications emerge late in puberty or are underreported. The expectations for surgical success have evolved, shifting from basic urinary and sexual functionality to achieving a normal penile appearance. Bias in research favors retrospective studies with short follow-ups, and qualitative research remains scarce. This review describes complications following hypospadias surgery, their management, and prognosis. METHODOLOGY: A non-systematic critical review of existing literature on hypospadias complications and surgical management was conducted. RESULTS: Common complications include urethrocutaneous fistulae (UCF), glans dehiscence (GD), urethral stenosis (US), urethral diverticulae (UD), urine spraying, and recurrent curvature (RC). UCF is the most frequently reported complication, treated through multilayer closure with vascularized flap coverage. GD occurs more frequently in proximal hypospadias, requiring glans reformatting and tissue augmentation. US often manifests as meatal stenosis or neourethral strictures, requiring meatoplasty or staged urethroplasty. UD arises from loose urethral segments subjected to high urinary flow resistance and is managed via excision or remodeling. Urine spraying is linked to insufficient glans fusion or meatal irregularities, sometimes requiring surgical correction. RC is a significant complication impacting sexual function, requiring individualized correction through dorsal plication or ventral lengthening. CONCLUSION: Hypospadias complications require individualized assessment and surgical planning. Late complications, often underrecognized, should be considered in long-term follow-up. Proper surgical technique selection and postoperative evaluation help mitigate recurrence and improve patient outcomes.
INTRODUCTION AND OBJECTIVES: To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment. MATERIALS AND METHODS: A retrospective study of patients who underwent percutan...INTRODUCTION AND OBJECTIVES: To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment. MATERIALS AND METHODS: A retrospective study of patients who underwent percutaneous nephrolithotripsy for staghorn stones and long term follow up were divided into two groups: residual stones versus non-residual stones. The occurrence of new stones or fragment growth, infectious events, and renal function were evaluated. Patients with a follow-up period of less than one year were excluded. RESULTS: A total of 87 patients (75.9% female) were included in the study. Of these, 21.8% were stone-free, while 78.2% exhibited residual fragments with a median size of 7mm (3.5-11.5mm). The average follow-up period was 27 months (21-36 months). Only 24.1% experienced recurrence or growth of residual fragments, with a median growth of 10mm (6-12mm). Additionally, 14.9% of patients developed urinary infections during the follow-up period. No significant differences were observed between stone-free patients and those with residual fragments in terms of recurrence, residual fragments growth, infectious events, or deterioration in renal function. Similarly, no differences were noted when comparing patients with positive or negative cultures. CONCLUSIONS: The incidence of recurrence, growth of residual fragments, infectious events, and deterioration of renal function was comparable between patients with and without residual stones. Furthermore, the presence of positive preoperative or intraoperative cultures did not influence these outcomes.
INTRODUCTION: This study investigates testicular cancer (TC) mortality trends and spatial patterns in Spain, utilizing provincial-level spatial analysis to identify high-risk clusters. METHODS: An ecological study was co...INTRODUCTION: This study investigates testicular cancer (TC) mortality trends and spatial patterns in Spain, utilizing provincial-level spatial analysis to identify high-risk clusters. METHODS: An ecological study was conducted using TC mortality data (ICD-10 code C62) from the Spanish National Institute of Statistics (2004-2023). Age-standardized mortality rates (ASMRs) were calculated using the direct method. Temporal trends were analyzed with joinpoint regression. Spatial patterns were assessed using standardized mortality ratios (SMR), smoothed relative risk (RR), and posterior probabilities (PP) through Bayesian hierarchical models. Spatial clustering was examined with Tango's test and Kulldorff's likelihood ratio test. RESULTS: A total of 909 TC deaths were recorded, with ASMRs ranging from 0.14 to 0.26 per 1,000,000 inhabitants. No significant temporal trends were observed. Age-specific mortality showed a bimodal distribution, peaking at ages 35-39 and 85+. The highest SMRs were found in Zamora (2.58), Segovia (2.64), and Soria (2.39), while the lowest were in Madrid (0.66) and Barcelona (0.55). Bayesian spatial analysis identified elevated relative risk in Badajoz (RR 1.6), Huelva (RR 1.47), and Sevilla (RR 1.4). Kulldorff's analysis revealed a high-mortality cluster in southwestern Spain (Huelva, Sevilla, Badajoz), with a secondary cluster extending to neighbouring provinces. CONCLUSIONS: While TC mortality in Spain remained stable, significant regional disparities exist. High-risk provinces and mortality clusters highlight potential inequalities in healthcare access, socioeconomic conditions, and environmental exposures.
INTRODUCTION: Renal cell carcinoma (RCC) invades the inferior vena cava (IVC) in 4%-10% of cases, increasing the risk of surgical complications that affect oncological outcomes. MATERIALS AND METHODS: The research questi...INTRODUCTION: Renal cell carcinoma (RCC) invades the inferior vena cava (IVC) in 4%-10% of cases, increasing the risk of surgical complications that affect oncological outcomes. MATERIALS AND METHODS: The research question was defined using the PICOST acronym. An exhaustive search, material selection, and data extraction were conducted in duplicate and independently. Original articles were included on patients with metastatic RCC (mRCC) with thrombus in the IVC, treated with immune checkpoint inhibitors with or without tyrosine kinase inhibitors (TKIs) and cytoreductive nephrectomy (CN). Studies involving patients with thrombi localized solely to the renal artery or atrium were excluded. RESULTS: A total of 17 articles were included: one retrospective cohort, five retrospective case series, and 11 retrospective case reports. In total, 32 patients were analyzed; 10 were excluded due to the absence of metastases. In most cases, the size of the primary tumor decreased. Regarding the thrombus in the IVC, based on the level, out of 22 patients, 7 remained unchanged, 13 showed a reduction (9 by one level, 3 by two levels, and 1 by three levels), and one showed an increase. In another case, the magnitude of the reduction in thrombus size or level was not specified. Tumor thrombus size decreased even in cases where the level remained unchanged. CONCLUSIONS: Patients with mRCC and thrombus in the IVC may benefit from neoadjuvant treatment with immune checkpoint inhibitors, with or without TKIs, and delayed cytoreductive nephrectomy.
INTRODUCTION: Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees...INTRODUCTION: Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training. METHODS: Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September-October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction. RESULTS: Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fistula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol. CONCLUSION: There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.
OBJECTIVE: To summarize the key findings of occupational exposures during aluminum production in cohort studies on bladder cancer published between 1979 and 2023. MATERIALS AND METHODS: This systematic review was conduct...OBJECTIVE: To summarize the key findings of occupational exposures during aluminum production in cohort studies on bladder cancer published between 1979 and 2023. MATERIALS AND METHODS: This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Study quality was evaluated using the Newcastle-Ottawa scale. RESULTS: The literature search identified 24 cohort studies examining the standardized incidence (SIR) and mortality ratios (SMR) of bladder cancer among aluminum production workers. Five of the 13 studies examined SIR (95% CI) and three of the 16 studies that examined SMR (95% CI) reported a statistically significant increased risk of bladder cancer among aluminum production workers. The highest SIR was recorded in the secondary aluminum smelter (2.85; 95% CI: 1.23-5.62), suggesting a significantly elevated risk. In aluminum reduction plants, the SIR was 1.82 (95% CI: 1.59-2.07), while in Söderberg plants, it was 1.69 (95% CI: 1.06-2.57) and 1.4 (95% CI: 1.0-1.9), respectively. For aluminum plants overall, the SIR was 1.30 (95% CI: 1.10-1.50). The results indicate an increased risk, with the highest SMR of 5.90 (95% CI: 1.58-15.1), suggesting a significantly elevated hazard in the secondary aluminum smelter. The other values-3.47 (95% CI: 1.25-9.62) for the aluminum smelter and 2.24 (95% CI: 1.77-2.79) for the aluminum reduction plant-also indicate an increased risk, albeit with varying degrees of statistical certainty. CONCLUSION: The International Agency for Research on Cancer has classified aluminum production as a Group 1 carcinogenic activity, providing strong evidence of its association with bladder cancer. The studies primarily included workers from Prebake, Söderberg, and aluminum reduction plants. Some findings indicate a significant yet variable risk across different segments of aluminum production. However, the review did not clearly confirm an increased risk of bladder cancer in specific aluminum-related occupations. Aluminum exposure may influence the lifetime risk of bladder cancer among these workers.