Int Urol Nephrol [JOURNAL]
Sun
200 papers
Predictors of residual tumour and recurrence in high-grade NMIBC: insights from a multicenter re-TURBT cohort.
Jaabou M, Dovey Z, Zaytoun O … +11 more , Awan M, Hildebrand B, Bada M, Signore S, Falavolti C, Di Marco M, Martini A, Papalia R, Bellido J, Rabie A, Buscarini M
Int Urol Nephrol · 2026 Jul · PMID 42400747 · Publisher ↗
BACKGROUND: Repeat transurethral resection of bladder tumour (re-TURBT) is recommended in high-risk non-muscle-invasive bladder cancer (NMIBC) to improve staging and identify residual disease. Nevertheless, whether it sh...
BACKGROUND: Repeat transurethral resection of bladder tumour (re-TURBT) is recommended in high-risk non-muscle-invasive bladder cancer (NMIBC) to improve staging and identify residual disease. Nevertheless, whether it should be performed routinely in current practice remains uncertain. We examined the findings of re-TURBT in a multicentre cohort and assessed factors associated with residual tumour and later recurrence. METHODS: This retrospective multicentre study included 567 patients with high-grade NMIBC who underwent re-TURBT after primary resection between 2018 and 2024. Clinicopathological variables and oncological outcomes were reviewed. Logistic regression analysis was used to evaluate predictors of residual tumour, and Cox regression analysis was used to assess factors associated with recurrence. RESULTS: Residual tumour was found in 152 patients (26.8%), and 34 patients (6.0%) were upstaged to muscle-invasive disease. Sessile morphology (OR 1.9, 95%CI 1.3-2.6), multifocal tumours (OR 2.3, 95%CI 1.7-3.2), concomitant carcinoma in situ (OR 2.6, 95%CI 1.9-3.7), and lymphovascular invasion (OR 1.7, 95%CI 1.1-2.4) were independently associated with residual disease. Absence of detrusor muscle in the initial specimen was associated with a higher risk of residual tumour (p < 0.001). Patients with residual tumour had poorer recurrence-free survival. On multivariable Cox analysis, residual tumour (HR 1.95, 95%CI 1.42-2.70), multifocality (HR 2.10, 95% CI 1.55-2.85), carcinoma in situ (HR 1.78, 95%CI 1.30-2.42), and tumour size ≥ 3 cm (HR 1.45, 95%CI 1.05-2.02) were independently associated with recurrence. The overall complication rate was 4.2%, and no major perioperative complications at re-TURBT were recorded. CONCLUSIONS: Residual tumour after initial TURBT remains frequent in patients with high-grade NMIBC. Repeat resection improves staging, detects occult muscle-invasive disease, and helps identify patients at greater risk of recurrence. These findings support an ongoing role for re-TURBT, particularly in carefully selected high-risk patients.
Systematic review and meta-analysis of randomized controlled trials: low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction after radical prostatectomy.
Zhou Z, Cheng Z, Wei G … +1 more , Zhang Y
Int Urol Nephrol · 2026 Jul · PMID 42397517 · Publisher ↗
OBJECTIVE: The efficacy of Low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) in patients undergoing radical prostatectomy (RP) remains poorly recognized. To address this, we conducted...
OBJECTIVE: The efficacy of Low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) in patients undergoing radical prostatectomy (RP) remains poorly recognized. To address this, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of this intervention. METHODS: From January 2000 to May 2025, five RCTs were selected, involving a total of 297 patients from PubMed, EMBASE, and the Cochrane Library to evaluate the efficacy of Li-ESWT for ED in patients undergoing RP. RESULTS: At the 8- and 12-week assessments following Li-ESWT, participants who underwent Li-ESWT demonstrated significantly greater improvements in IIEF scores compared with those in the control group (8-week: MD 2.80, P < 0.0001; 12-week: MD 2.10, P = 0.004). In contrast, no significant differences in IIEF scores were detected between the Li-ESWT and control groups at 24 weeks and beyond post-treatment. CONCLUSION: Li-ESWT significantly improves short-term erectile function in patients following RP. However, this therapeutic benefit was not sustained beyond 24 weeks. Accordingly, further research is warranted to investigate novel strategies and combination therapies aimed at preserving long-term erectile function after RP.
Multiparametric MRI-derived radiomic signatures enable noninvasive prediction of HER2 expression in bladder cancer.
Wang Y, Zhao T, Liang B … +7 more , Zhen L, Ding Y, Jiang Y, Wu J, Meng Y, Mao W, Chen M
Int Urol Nephrol · 2026 Jul · PMID 42397516 · Publisher ↗
OBJECTIVE: To assess the value of multiparametric MRI (mpMRI)-derived radiomic signatures and a combined model for non-invasive prediction of human epidermal growth factor receptor 2 (HER2) expression in bladder cancer (...
OBJECTIVE: To assess the value of multiparametric MRI (mpMRI)-derived radiomic signatures and a combined model for non-invasive prediction of human epidermal growth factor receptor 2 (HER2) expression in bladder cancer (BCa). METHODS: A total of 113 BCa patients with preoperative pelvic mpMRI were retrospectively enrolled. Radiomic features were extracted from T2WI, DWI, DCE and their combinations. Five machine learning algorithms were used to construct radiomic models. A combined model and a nomogram were developed by integrating radiomic signatures and clinicoradiological variables. RESULTS: The T2WI + DWI + DCE-based RandomForest model achieved the best performance, with an AUC of 0.877 in the training cohort and 0.754 in the validation cohort. Age, risk group, and maximum tumor diameter were independent predictors of HER2 overexpression. The combined model yielded AUCs of 0.808 and 0.870 in the training and validation cohorts, respectively. CONCLUSION: mpMRI radiomics can non-invasively predict HER2 expression in BCa. The combined nomogram shows good clinical utility, supporting personalized treatment planning for BCa patients.
Does WHO/ISUP grade IV histology provide prognostic insight in chromophobe renal cell carcinoma?
Turan S, Erdem S, Mert S … +3 more , Çilesiz NC, Aydinoglu AT, Balci C
Int Urol Nephrol · 2026 Jul · PMID 42390700 · Publisher ↗
OBJECTIVE: Chromophobe renal cell carcinoma (chRCC) is generally considered a less aggressive renal malignancy, yet a clinically meaningful subset displays adverse outcomes. We evaluated the prognostic impact of WHO/ISUP...
OBJECTIVE: Chromophobe renal cell carcinoma (chRCC) is generally considered a less aggressive renal malignancy, yet a clinically meaningful subset displays adverse outcomes. We evaluated the prognostic impact of WHO/ISUP Grade IV histology on cancer-specific survival (CSS) in a large population-based, propensity score-matched cohort. METHODS: The SEER database (2000-2021) was queried for patients with chRCC. Patients were stratified according to WHO/ISUP grade into Grade IV chRCC and Grade I-III chRCC. The primary endpoint was CSS. A 2:1 nearest-neighbor PSM was performed using age, sex, race, AJCC stage, and tumor size. Fine-Gray competing-risk regression was performed in both the overall and propensity score-matched cohorts. RESULTS: A total of 6243 patients with chRCC were identified, including 394 (6.3%) with Grade IV histology. In the overall cohort, Grade IV chRCC was independently associated with worse CSS (HR 2.38, 95%CI 1.78-3.18, p < 0.001). After PSM (n = 1107), this association persisted (HR 1.96, 95%CI 1.43-2.69, p < 0.001) and was supported by competing-risk analysis in both the overall cohort (sHR 2.07, 95% CI 1.53-2.79, p < 0.001) and the matched cohort (sHR 1.80, 95%CI 1.32-2.46, p < 0.001). CONCLUSION: In this large, propensity score-matched, population-based cohort, WHO/ISUP Grade IV chRCC was independently associated with poorer CSS, even after adjustment for tumor burden and stage. These findings should be interpreted within the limitations of registry-defined Grade IV classification.
Age-stratified association between blood pressure and clinical outcomes in maintenance hemodialysis patients.
Kang SH, Park SY, Lim YJ … +3 more , Choi JY, Kim BY, Do JY
Int Urol Nephrol · 2026 Jun · PMID 42377860 · Publisher ↗
BACKGROUND: Few studies have directly compared outcomes according to blood pressure (BP) levels across different age groups in hemodialysis (HD) patients. This study aimed to identify the optimal pre-dialysis BP range as...
BACKGROUND: Few studies have directly compared outcomes according to blood pressure (BP) levels across different age groups in hemodialysis (HD) patients. This study aimed to identify the optimal pre-dialysis BP range associated with key clinical outcomes across different age groups in a large cohort of patients undergoing HD. METHODS: We analyzed 42,258 maintenance HD patients, retrospectively linked to claims and mortality data. Pre-dialysis BP was categorized into six systolic and six diastolic ranges. Baseline demographics, comorbidities, laboratory markers, and medication use were extracted. Patients were followed until June 2024 for all-cause mortality, cardiovascular events, dementia, and fractures. Outcomes were assessed with Kaplan-Meier curves and Cox proportional hazards models, adjusting for demographic, clinical, and treatment variables. RESULTS: Baseline characteristics differed significantly across age groups (< 65, 65-74, ≥ 75 years). Higher systolic and diastolic BP values were associated with increased risks of all-cause mortality and cardiovascular events in most groups. Mildly reduced BP levels were often protective, particularly against CVEs. In younger patients, elevated BP was linked to higher risks of dementia and fractures, while in older groups, associations were weaker or reversed. Overall, elevated BP conferred excess risk, whereas modestly lower BP tended to reduce adverse outcomes, highlighting age-specific variations in prognostic impact. CONCLUSIONS: Our results suggest that intensive BP control is necessary for favorable outcomes regardless of age, except in cases of severe hypotension in younger patients.
Management and implementation of intermittent catheterisation in neurogenic lower urinary tract dysfunction: a clinical practice guideline in Germany - update 3.0.
Kurze I, Geng V, Wenig P … +2 more , König M, Böthig R
Int Urol Nephrol · 2026 Jun · PMID 42374014 · Publisher ↗
BACKGROUND: Although intermittent catheterisation (IC) has been established as the standard method of bladder emptying in cases of neurogenic bladder dysfunction since the 1960s, there are still many uncertainties in eve...
BACKGROUND: Although intermittent catheterisation (IC) has been established as the standard method of bladder emptying in cases of neurogenic bladder dysfunction since the 1960s, there are still many uncertainties in everyday nursing practice regarding the specific implementation of IC. It, therefore, seemed necessary to standardise the IC procedure and develop specific recommendations for performing IC based on an interprofessional, interdisciplinary consensus process. METHODS: In 2014, an interprofessional, interdisciplinary working group developed initial Clinical Practice Guidelines (CPG) in accordance with the rules of the Association of the Scientific Medical Societies in Germany (AWMF) based on the evidence level of a structured consensus process. The methods used to develop the CPG and the professional associations involved are described in detail. These CPG have been consistently refined and have been available as update 3.0 since 2026. RESULTS: The CPG describes in detail the topics of indications for IC, definitions, detailed descriptions of the various catheter characteristics, specific implementation of IC including disinfection of hands and meatus urethrae, management of complications such as urinary tract infections (UTIs) or autonomic dysreflexia, and options for UTI prophylaxis, and provides specific recommendations for action. CONCLUSIONS: This CPG, based on consensus-based evidence, has proven itself in clinical and everyday use for over 10 years. Due to the regular further development of the CPG, the guideline will also be able to meet future challenges such as changing demographic conditions of our patients with an increase in older patients with complex medical situations and increased use of permanent urinary catheter drainage or increased cost pressure in the healthcare system, even in developed countries. Consensus-based CPGs are an important component of evidence-based medicine, especially in situations where there are few randomised-controlled trials and none are expected in the future. Such CPGs can also address aspects that are likely to become even more important in the future, such as sustainability and environmental issues.
Interpreting short-term eGFR improvement with telitacicept in IgA nephropathy.
Pang S, Yan Q, Yue L
Int Urol Nephrol · 2026 Jun · PMID 42371351 · Publisher ↗
Abstract loading — click title to view on PubMed.
Medical expulsive therapies for ureteric stones: an umbrella review of network meta-analyses with novel evidence grading.
Banatwala UESS, Mansoor A, Fawzy M … +3 more , Khan SA, Nusrat NB, Khan KS
Int Urol Nephrol · 2026 Jun · PMID 42371350 · Publisher ↗
BACKGROUND: There is uncertainty about the ranking of effectiveness of the available medical expulsive therapies (MET) for ureteric stones, a common and painful urological condition. We comprehensively compared all curre...
BACKGROUND: There is uncertainty about the ranking of effectiveness of the available medical expulsive therapies (MET) for ureteric stones, a common and painful urological condition. We comprehensively compared all currently available METs employing a novel evidence grading system to evaluate published network meta-analyses (NMA). METHODS: Following prospective registration (PROSPERO CRD #42023472770), we conducted an umbrella review incorporating NMAs of randomized controlled trials (RCTs) evaluating various METs. Literature searches were performed in PubMed, Embase, and Google Scholar until January 2026. The primary outcome was the rate of ureteric stone expulsion. Calculated covered area (CCA) estimated the overlap of studies between NMAs. Evidence certainty was assessed using a novel modified GRADE methodology incorporating AMSTAR-2. Surface under the cumulative ranking curve (SUCRA) based on probability of being the best intervention was used for comparing METs. RESULTS: Eight NMAs, comprising 147 RCTs were selected. The CCA showed high (24.5%) overall overlap. Evidence certainty was high-moderate in 5 NMAs, and low in 3. The highest-ranked METs were Naftopidil plus corticosteroids (SUCRA 91.8% and 90.6% in 1 high and 1 moderate certainty NMA) and Silodosin (SUCRA 94.8% and 82.5% in 1 moderate and 1 low certainty NMA). CONCLUSIONS: Naftopidil plus corticosteroids was the most effective MET for stone expulsion based on evidence certainty assessment, followed by Silodosin. Clinical care and future research should take into account the ranking evidence collated in this umbrella review.
Associations between PM2.5 exposure and upper tract urothelial carcinoma in a taiwanese case-control study.
Liu CI, Chen SC, Geng JH … +1 more , Wu WJ
Int Urol Nephrol · 2026 Jun · PMID 42363990 · Publisher ↗
BACKGROUND: Upper tract urothelial carcinoma (UTUC) has a disproportionately high incidence in Taiwan, traditionally linked to aristolochic acid and arsenic exposure. Fine particulate matter (PM2.5), a Group 1 carcinogen...
BACKGROUND: Upper tract urothelial carcinoma (UTUC) has a disproportionately high incidence in Taiwan, traditionally linked to aristolochic acid and arsenic exposure. Fine particulate matter (PM2.5), a Group 1 carcinogen, has been associated with various malignancies, but its role in UTUC remains unclear. This study investigated the association between PM2.5 exposure and UTUC risk. METHODS: This retrospective case-control study used data from the Kaohsiung Medical University Hospital Research Database. Among 349,954 individuals, 74 UTUC cases (2012-2020) were identified and matched with 296 controls (1:4) using propensity score matching for age and sex. PM2.5 exposure was assessed using the PM2.5 concentration on the index date and the mean PM2.5 concentrations during the 1, 2, 3, and 5 years preceding the index date. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) per interquartile range (IQR) increase in PM2.5 exposure. Multivariable models were adjusted for age, sex, smoking status, diabetes mellitus, hypertension, and hyperlipidemia. Sensitivity analyses were performed by excluding participants with a history of smoking and by further adjusting for α-blocker use. RESULTS: UTUC patients had significantly higher PM2.5 exposure across all evaluated exposure periods (all p < 0.01). In multivariable conditional logistic regression analyses, higher PM2.5 concentrations were associated with increased odds of UTUC, with adjusted odds ratios ranging from 1.436 to 2.719 per interquartile range increase in PM2.5 exposure. Similar findings were observed in sensitivity analyses excluding smokers and after further adjustment for α-blocker use. CONCLUSION: Higher PM2.5 concentrations across multiple evaluated exposure periods were associated with increased odds of UTUC in this Taiwanese case-control study. These findings suggest that ambient air pollution may contribute to UTUC risk and warrant further investigation in larger studies with more detailed information on established risk factors and individual exposure histories.
APRIL-targeted and dual BAFF/APRIL blockade in primary IgA nephropathy: a systematic review and meta-analysis of randomized placebo-controlled trials.
Qu B, Zhu L, Ren Q … +2 more , Wang B, Mao B
Int Urol Nephrol · 2026 Jun · PMID 42350870 · Publisher ↗
PURPOSE: APRIL-targeted and dual BAFF/APRIL blockade are upstream immune approaches for primary IgA nephropathy. We evaluated their efficacy and safety in adults with this disease. METHODS: PubMed/MEDLINE, Embase, Web of...
PURPOSE: APRIL-targeted and dual BAFF/APRIL blockade are upstream immune approaches for primary IgA nephropathy. We evaluated their efficacy and safety in adults with this disease. METHODS: PubMed/MEDLINE, Embase, Web of Science, CENTRAL, ClinicalTrials.gov, WHO ICTRP and other registries were searched from inception to 8 May 2026. Randomized placebo-controlled trials of APRIL-targeted or dual BAFF/APRIL blockade in adults with biopsy-confirmed primary IgA nephropathy were included. The primary outcome was relative change in proteinuria, analyzed as the log ratio of means and back-transformed to the ratio of means (RoM). Serious adverse events were pooled as odds ratios. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE. RESULTS: Nine full-text reports representing six independent trials were included. Five trials with 768 participants contributed to the primary proteinuria analysis. Active treatment reduced proteinuria versus placebo, with a pooled RoM of 0.539 (95%CI 0.477-0.609; p < 0.0001), corresponding to 46.1% lower proteinuria. Heterogeneity was low (I = 21.3%), and results were stable across sensitivity analyses. eGFR outcomes were summarized narratively because reporting was heterogeneous. Six trials with 1269 participants contributed to the safety analysis. Active treatment was not associated with a higher incidence of serious adverse events (OR 0.582, 95%CI 0.318-1.064). CONCLUSION: APRIL-targeted and dual BAFF/APRIL blockade reduced short-to-medium-term proteinuria in adults with primary IgA nephropathy. Longer follow-up is needed to clarify durability, immune safety and kidney outcome benefits.
Application of targeted next-generation sequencing in the etiological diagnosis of peritoneal dialysis-associated peritonitis: a single-center prospective cohort study.
Ma N, Pu L, Zang Z … +5 more , Zhang Y, Liao R, Liu X, Tang Y, Li Z
Int Urol Nephrol · 2026 Jun · PMID 42348136 · Publisher ↗
BACKGROUND: Accurate and rapid pathogen identification is crucial for the effective treatment of peritoneal dialysis-associated peritonitis (PDAP). Targeted next-generation sequencing (tNGS) has gained popularity for det...
BACKGROUND: Accurate and rapid pathogen identification is crucial for the effective treatment of peritoneal dialysis-associated peritonitis (PDAP). Targeted next-generation sequencing (tNGS) has gained popularity for detecting infectious diseases due to its defined pathogen targeting and enhanced detection efficiency. However, its application in the etiological diagnosis of PDAD has not been fully investigated. METHODS: This prospective study enrolled 35 PDAP patients from November 2023 to January 2025. Both tNGS and traditional microbial culture (TMC) were performed in the peritoneal dialysate simultaneously, with TMC as the reference standard. Discrepant results were adjudicated by clinicians with priority given to TMC. RESULTS: tNGS achieved a significantly higher pathogen detection rate (PDR) than TMC (82.9% vs. 48.6%, P = 0.008) and detected 10 polymicrobial infections, whereas TMC identified none. Beyond common pathogens, tNGS also detected rare ones, including Human herpesvirus and the Mycobacterium tuberculosis complex. tNGS also had a significantly shorter detection time than TMC (22.63 h vs. 66.37 h, P < 0.001). Among the patients with prior antibiotic exposure (54.3%), tNGS maintained a higher PDR than that of TMC (89.5% vs. 26.3%, P < 0.001). CONCLUSIONS: tNGS showed a significantly higher PDR and a shorter detecting time than TMC in patients with PDAP, particularly in those with prior antibiotic exposure. Additionally, this method enables the identification of rare pathogens that are undetectable by TMC. As a complementary tool to conventional methods, combining tNGS with TMC may enable more comprehensive and rapid pathogen diagnosis, thereby improving diagnostic accuracy and patient prognosis. TRIAL REGISTRATION: This study was registered in the China Clinical Trials Registry (ChiCTR2300078924).
Low-intensity shock wave therapy for penile rehabilitation in patients with erectile dysfunction following pelvic fracture urethral injury: a pilot study.
Fathi A, Alsagheer G, Talaat M … +1 more , AbdelRazek M
Int Urol Nephrol · 2026 Jun · PMID 42334516 · Publisher ↗
PURPOSE: Pelvic fracture urethral injury (PFUI) frequently results in long-term erectile dysfunction (ED), severely impacting quality of life. Low-intensity shockwave therapy (LiSWT) promotes neovascularization and tissu...
PURPOSE: Pelvic fracture urethral injury (PFUI) frequently results in long-term erectile dysfunction (ED), severely impacting quality of life. Low-intensity shockwave therapy (LiSWT) promotes neovascularization and tissue perfusion via VEGF and nitric oxide pathways, offering a potential regenerative treatment for post-traumatic ED. This study aims to evaluate the efficacy and safety of LiSWT for ED secondary to urethral injury from pelvic fractures. METHODS: This pilot study included 25 men with ED post-PFUI. Participants received six weekly sessions of LiSWT (24,000 shocks total) using a piezoelectric device. Assessments included the International Index of Erectile Function (IIEF) and Erectile Hardness Scale (EHS) at baseline and at 3, 6, and 12 months' post-treatment, while penile Doppler ultrasound was done at baseline and 12 months' post-treatment. RESULTS: IIEF scores improved significantly from 14.4 ± 3.2 at baseline to 17.4 ± 3.2 (p = 0.002) post-LiSWT, 16.4 ± 3.2 (p = 0.036) at 3 months, 17.4 ± 3.2 (p = 0.002) at 6 months, and 17.8 ± 3.7 (p < 0.001) at 12 months. EHS increased significantly at all follow-ups (p < 0.001), with a further rise between 3 months 2.35 ± 0.53 and 12 months 2.74 ± 0.58 (p = 0.009). PSV increased from 23.4 ± 6.1 at baseline to 34.1 ± 9.1 (p < 0.001) at 12 months, EDV decreased from 6.68 ± 2.95 at baseline to 3.84 ± 2.70 (p = 0.002) at 12 months, and RI increased from 0.66 ± 0.22 at baseline to 0.86 ± 0.13 (p < 0.001) at 12 months. CONCLUSION: LiSWT is safe and effective for ED after PFUI, producing sustained improvements in erectile function, penile rigidity, and hemodynamics, representing a promising noninvasive therapeutic option for post-traumatic ED. TRIAL REGISTRATION: ClinicalTrials.gov NCT07460167, registered 10 March 2026, retrospectively registered.
Conceptual and interpretive considerations in MRI-based characterisation of urethral biomechanics during voiding.
Rizwan A, Batool SM, Batool SE … +3 more , Zaidi SMAR, Afzal AMI, Saeed MH
Int Urol Nephrol · 2026 Jun · PMID 42329502 · Publisher ↗
Abstract loading — click title to view on PubMed.
Three-dimensional virtual models accurately predict preserved parenchymal volume after robot-assisted partial nephrectomy: a prospective study.
Hevia V, García-Rojo E, Paesano N … +9 more , Pérez-Ruiz JM, Barrientos-Moll F, Sáenz-Calzada D, Duque-Ruiz G, González-Gallego C, Brime-Menéndez R, Lista-Mateos F, Justo-Quintas J, Romero-Otero J
Int Urol Nephrol · 2026 Jun · PMID 42329501 · Publisher ↗
INTRODUCTION: Accurate prediction of postoperative renal function remains a challenge in robot-assisted partial nephrectomy (RAPN). Preserved parenchymal volume (PPV) has emerged as a key determinant of long-term renal f...
INTRODUCTION: Accurate prediction of postoperative renal function remains a challenge in robot-assisted partial nephrectomy (RAPN). Preserved parenchymal volume (PPV) has emerged as a key determinant of long-term renal function. Three-dimensional virtual models (3DVM) enable patient-specific anatomical reconstruction and volumetric quantification, potentially allowing preoperative estimation of PPV. However, their accuracy in predicting postoperative PPV and functional outcomes has not been prospectively validated. This study aimed to assess the accuracy of 3DVM in predicting PPV after RAPN and to explore their relationship with postoperative renal function and anatomical complexity. MATERIALS AND METHODS: A prospective single-centre study included patients undergoing RAPN with preoperative 3DVM-based planning (2022-2024). Estimated preoperative PPV was compared with real postoperative PPV obtained from follow-up 3DVM. Agreement was evaluated using paired statistics and Spearman's correlation. Functional outcomes (serum creatinine, eGFR) were correlated with PPV and WIT, whilst tumour complexity was assessed by PADUA and RENAL scores. RESULTS: Twenty-nine patients were included (mean age 59.7 years; 72% male). Median estimated PPV was 156.7 ml and real postoperative PPV was 148.6 ml, with a mean absolute difference of 7.3 ml (~ 6%). Estimated and real PPV were strongly correlated (ρ = 0.97; p < 0.0001). PADUA score correlated negatively with postoperative eGFR (ρ ≈ -0.4; p < 0.05), whilst RENAL score and WIT did not. Median parenchymal loss was 6%, with low morbidity (17% Clavien I-II). CONCLUSIONS: 3DVM accurately predict postoperative PPV after RAPN, showing excellent concordance with real volumetric measurements. Integration of 3D volumetry into surgical planning may provide a quantitative tool to support nephron-sparing strategies and functional preservation.
From black box to glass box: explainable artificial intelligence for acute kidney injury prediction-a scoping review and the GLASS-AKI translational framework proposal.
Lin WL, Fang SS, Chen SH
Int Urol Nephrol · 2026 Jun · PMID 42322494 · Publisher ↗
BACKGROUND: Artificial intelligence models for acute kidney injury (AKI) prediction achieve strong discriminative accuracy, yet clinical adoption remains constrained by model opacity and alarm fatigue. Explainable artifi...
BACKGROUND: Artificial intelligence models for acute kidney injury (AKI) prediction achieve strong discriminative accuracy, yet clinical adoption remains constrained by model opacity and alarm fatigue. Explainable artificial intelligence (XAI) methods may enhance clinician trust and alert acceptance; however, the extent of their clinical validation and implementation remains unclear. METHODS: We performed a scoping review following PRISMA-ScR guidelines. PubMed, Embase, Web of Science, CINAHL, IEEE Xplore, and ACM Digital Library were searched from January 2012 through February 2026. Studies applying XAI methods to AKI prediction or management in adult inpatients were eligible. Prediction model studies were appraised using PROBAST. We additionally propose the GLASS-AKI conceptual framework as a structured research agenda derived from identified gaps. RESULTS: Thirty-four studies met inclusion criteria (total patient population > 2.1 million). SHAP-based attribution was the most frequently reported XAI technique (26/34; 76.5%), followed by LIME (9; 26.5%), attention-weight visualization (7; 20.6%), and rule-based surrogates (5; 14.7%). Reported AUROC values ranged from 0.71 to 0.95 (median 0.84). Critically, XAI was applied as a post hoc explanation method in 88.2% of studies and did not inherently alter model discriminative performance. Prospective clinical deployment data were limited to 4 studies (11.8%). PROBAST assessment identified high overall risk of bias in 79.4% of studies, predominantly in the Analysis domain. No study integrated multi-omic biomarker signals with real-time XAI reasoning at the point of care. CONCLUSIONS: XAI methods are increasingly applied to AKI prediction models, but prospective evidence linking explainability to improved clinician behavior or patient outcomes remains limited. We propose the GLASS-AKI framework as a conceptual research agenda-not a validated system-to guide future multicenter prospective evaluation of integrated XAI-biomarker approaches.
Penile curvature surgery in contemporary practice: effectiveness, satisfaction, and complications after corporoplasty in a tertiary referral center.
Sánchez-Curbelo JR, Raffo M, Treviño GC … +11 more , Luft DV, Suñé ÁV, Soldi JAA, Caballero LM, Dumas S, De Rocco Ponce M, García RC, Adalid G, Montorsi F, Salonia A, Ruiz-Castañé E
Int Urol Nephrol · 2026 Jun · PMID 42313324 · Publisher ↗
PURPOSE: Penile curvature due to Peyronie's disease (PD) or congenital penile curvature (CPC) may impair sexual function and quality of life. We aimed to evaluate effectiveness, safety, and patient satisfaction after cor...
PURPOSE: Penile curvature due to Peyronie's disease (PD) or congenital penile curvature (CPC) may impair sexual function and quality of life. We aimed to evaluate effectiveness, safety, and patient satisfaction after corporoplasty at a tertiary referral center. METHODS: We retrospectively analyzed 324 men undergoing corporoplasty between 2020 and 2025. Patients were stratified according to curvature etiology (PD vs. CPC) and surgical technique (16-dot plication, Yachia, modified Nesbit, Surgisis grafting). Curvature severity was assessed during pharmacologically induced erection and classified as mild (< 30°), moderate (30-60°), or severe (> 60°). Outcomes assessed at 6-48 months included postoperative erectile function (IIEF-5), Global Assessment Questionnaire (GAQ-1/GAQ-2), satisfaction, complications, side effects, anesthesia type, and operative setting. RESULTS: 274 (84.6%) had PD and 50 (15.4%) CPC. Moderate curvature was present in 217 (67%) patients and severe curvature in 100 (31%). Local anesthesia was used in 256 (79%) cases, and 253 (78.1%) procedures were ambulatory. Overall, 181 (56%) patients reported normal postoperative erectile function, 211 (65%) improved sexual quality of life, and 249 (77%) satisfaction with surgery. Descriptively, CPC patients showed higher rates of preserved postoperative erectile function than PD patients (47 [94%] vs. 137 [50%]). Complete straightening was achieved in 298 (92%) patients, while re-curvature occurred in 26 (8%). Complications developed in 67 (20.7%) patients and side effects in 89 (27.5%), penile shortening being the most common. CONCLUSIONS: Corporoplasty provided high anatomical success and favorable patient satisfaction in both PD and CPC. CPC patients showed descriptively more favorable functional and satisfaction outcomes, while penile shortening and re-curvature represented the main determinants of dissatisfaction.
Deficit accumulation frailty and risk of incident chronic kidney disease: a prospective analysis of the UK biobank and CHARLS cohorts.
Qu L, Pan Z, Cheng L … +6 more , Jiang M, Gao M, Lu X, Wang G, Cai G, Pan F
Int Urol Nephrol · 2026 Jun · PMID 42295631 · Publisher ↗
BACKGROUND: Frailty is recognized as a clinical marker of reduced physiological reserve, but its longitudinal impact on renal health across diverse populations remains unclear. We investigated the association between bas...
BACKGROUND: Frailty is recognized as a clinical marker of reduced physiological reserve, but its longitudinal impact on renal health across diverse populations remains unclear. We investigated the association between baseline frailty and incident chronic kidney disease (CKD) risk in a European and an East Asian cohort. METHODS: We analyzed data from the UK Biobank (UKB, N = 451,067) and the China Health and Retirement Longitudinal Study (CHARLS, N = 7,013). Frailty was quantified using a deficit-accumulation Frailty Index (FI). Incident CKD was identified via electronic health records in UKB and biochemical testing or self-reports in CHARLS. Cox proportional hazards models and restricted cubic splines (RCS) were used to evaluate risks and dose-response relationships. The proportional hazards assumption was tested using Schoenfeld residuals, and Fine-Gray subdistribution hazard models were performed to account for the competing risk of death. Cumulative risk curves for incident CKD were plotted using the Kaplan-Meier method, and group differences were assessed with the log-rank test. Subgroup analyses were also performed. RESULTS: Over the median follow-up, frailty was significantly associated with incident CKD risk in both cohorts. In the UKB, hazard ratios (HRs) for pre-frailty and frailty compared to robust individuals were 1.64 (95% CI: 1.59, 1.69) and 2.75 (95% CI: 2.61, 2.89), respectively. In CHARLS, corresponding HRs were 1.45 (95% CI: 1.20, 1.75) and 1.69 (95% CI: 1.35, 2.11). Fine-Gray subdistribution hazard models confirmed the robustness of these findings to the competing risk of death (Table S5). We observed a significant interaction with age in both cohorts, with stronger associations in participants under 65 years. CONCLUSION: Frailty was associated with incident CKD in both cohorts. These findings support the value of frailty assessment for identifying individuals at elevated renal risk, particularly before age 65 years.
Micro-ultrasound guided versus multiparametric MRI-guided prostate biopsy: a systematic review and meta-analysis.
Moynagh N, Bruinsma J, Mac Curtain BM … +13 more , Calpin GG, Elfaki M, Nikolenko R, Deshwal A, Clausen N, Benour A, Qian W, Temperley HC, Lawlor P, Keane J, Cozman C, Yap LC, Daly PJ
Int Urol Nephrol · 2026 Jun · PMID 42295630 · Publisher ↗
PURPOSE: To investigate patients with suspected prostate cancer, multiparametric MRI (mpMRI) has been the standard imaging modality employed. However, mpMRI is costly and not universally available. Microultrasound (mUS),...
PURPOSE: To investigate patients with suspected prostate cancer, multiparametric MRI (mpMRI) has been the standard imaging modality employed. However, mpMRI is costly and not universally available. Microultrasound (mUS), a novel 29-MHz modality, offers high-resolution, real-time prostate imaging and may guide biopsy with comparable diagnostic accuracy. This systematic review and meta-analysis compares mUS-guided and mpMRI-guided prostate biopsy for the detection of prostate cancer (PCa). METHODS: A systematic search was conducted up to April 2025, in accordance with the PRISMA guidelines (PROSPERO ID CRD420251033768). Comparative studies reporting PCa detection between mUS and mpMRI were included. RESULTS: Twelve studies comprising 4318 patients (3475 mUS; 3615 mpMRI) were included. There was no significant difference between modalities in the detection of clinically significant prostate cancer (csPCa), both overall (RR 0.97; 95%CI 0.90-1.05) and with targeted biopsy (RR 1.05; 95%CI 0.97-1.14). Overall cancer detection was also comparable (RR 1.00; 95%CI 0.87-1.15), as was Grade Group 1 prostate cancer detection, whether assessed across all biopsies (RR 1.00; 95%CI 0.72-1.39) or with targeted biopsy alone (RR 0.90; 95%CI 0.64-1.27). Weighted pooled values showed mUS had a sensitivity of 93.2%, specificity of 23.3%, positive predictive value (PPV) of 46.4%, and negative predictive value (NPV) of 81.2%, compared with mpMRI's sensitivity of 87.5%, specificity of 25.7%, PPV of 44.6%, and NPV of 73.7%. CONCLUSION: mUS-guided biopsy demonstrates diagnostic performance comparable to mpMRI-guided biopsy for PCa detection and represents a promising alternative or adjunct to mpMRI in prostate cancer diagnostic pathways.
Evaluation of lighted catheter phototherapy in endoscopic treatment of urethral strictures: a rabbit pilot study.
Cedars B, Li G, Caza T … +4 more , Gopalakrishnan M, Donovan K, Bratslavsky G, Nikolavsky D
Int Urol Nephrol · 2026 Jun · PMID 42289626 · Publisher ↗
PURPOSE: To improve the success of minimally invasive urethral stricture treatments with red and near-infrared (NIR) light emitted via catheters after direct vision internal urethrotomy (DVIU). We hypothesized that cathe...
PURPOSE: To improve the success of minimally invasive urethral stricture treatments with red and near-infrared (NIR) light emitted via catheters after direct vision internal urethrotomy (DVIU). We hypothesized that catheter-emitted light therapy would improve success rate and histologic wound characteristics. METHODS: Twenty-four male New Zealand rabbits underwent stricture induction by electroresection and then were randomized into three groups: red light catheter (650 nm wavelength), NIR light (810 nm wavelength), or control (no light). After DVIU, a catheter was inserted for 7 days providing 5.4 J/cm/day. The primary endpoint was radiographic success (as defined by > 10% improvement in urethral lumen diameter). Secondary endpoints were improvement in histologic parameters. Cystoscopy and retrograde urethrogram were performed post-operatively. Hematoxylin and eosin and Masson-Trichrome stains were used for histology evaluation. RESULTS: One control rabbit had worsening stricture after DVIU, while no stricture in either treatment arm got worse. The red light group had 28% absolute improvement in stenosis, followed by NIR with 20%, and controls with 8% (p = 0.17). On pair-wise testing, NIR had significantly lower chronic inflammation compared to red (p = 0.024) and control (p = 0.033) groups, while red light had significantly higher vascularity compared to controls (p = 0.009). CONCLUSION: Catheters emitting red and NIR phototherapy after DVIU demonstrated improved reductions in stenosis, though these findings were not statistically significant. There were significant improvements in chronic inflammation with the NIR lighted catheter and in vascularity with the red light catheter. Cumulatively, these results suggest a promising adjunct to minimally invasive treatment in urethral stricture disease that warrants further investigation.
A critical appraisal of the causal association between sleep disorders and nephrolithiasis using Mendelian randomization.
Shahid A, Adnan E, Afzal M … +3 more , Prasad A, Ibraheem M, Ramzan H
Int Urol Nephrol · 2026 Jun · PMID 42288670 · Publisher ↗
Abstract loading — click title to view on PubMed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe