Riemann JS, Joensen UN, Røder A
… +1 more, Vejlgaard M
Int Urol Nephrol
· 2026 Mar · PMID 41840197
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PURPOSE: To identify risk factors for postoperative urinary tract infection (UTI) within 90 days following construction of a urinary diversion, and to assess the association between UTIs and results of renography scans 6...PURPOSE: To identify risk factors for postoperative urinary tract infection (UTI) within 90 days following construction of a urinary diversion, and to assess the association between UTIs and results of renography scans 6-8 weeks postoperatively. METHODS: A retrospective review of 612 patients who received a urinary diversion with or without radical cystectomy at Rigshospitalet, Denmark between January 2019 and January 2025. The primary outcome was UTI within 90 days after surgery, defined as presence of relevant symptoms, urine culture ≥ 10,000 CFU, and treatment with antimicrobials. Delayed excretion on Tc-99 m-MAG3 renography was defined as documentation thereof in the medical records by a urologist. Cox regression and multivariable logistic regression were performed to identify risk factors. RESULTS: A total of 346 UTIs occurred in 242 patients (40%) within 90 days after surgery. Bacteremia was present in 111 (32%) of the UTIs. Cox regression showed that female sex (HR = 1.5), BMI 25-30 kg/m (HR = 1.6), preoperative diabetes (HR = 1.7), orthotopic neobladder (HR = 2.1) or continent cutaneous reservoir (HR = 3.4), and early stent dislodgement (HR = 2.0) were all associated with an increased risk of UTI. On multivariable logistic regression, delayed excretion on postoperative renography was associated with higher UTI rate (OR = 1.7), whereas asymmetrical functional distribution was not (OR = 0.96). CONCLUSION: Postoperative UTI after urinary diversion is common and often complicated by bacteremia. Several risk factors for UTI within 90 days were identified, with the highest HR for continent diversions. Delayed excretion on renography was associated with occurrence of UTI, indicating that UTI is related to postoperative urine obstruction.
Matsuzawa R, Shimokado K, Takahashi K
… +5 more, Obama Y, Honda S, Tsujimoto N, Yamamoto H, Tamaki A
Int Urol Nephrol
· 2026 Mar · PMID 41840196
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PURPOSE: In patients undergoing hemodialysis, poor nutritional status frequently occurs due to depletion of essential nutrients, amino acids, during dialysis sessions. Protein supplementation during dialysis is becoming...PURPOSE: In patients undergoing hemodialysis, poor nutritional status frequently occurs due to depletion of essential nutrients, amino acids, during dialysis sessions. Protein supplementation during dialysis is becoming common to counteract this loss. We compared effects of intradialytic ingestion of fish protein, a novel protein source, with those of the traditionally used whey protein, on blood amino acid levels in patients undergoing hemodialysis. METHODS: Ten outpatients aged ≥ 60 years undergoing hemodialysis were enrolled in this single-intervention crossover study. Participants underwent three mid-week dialysis sessions with a one-week washout period. During the first session, blood and spent dialysate samples were collected without protein ingestion. In subsequent sessions, participants consumed fish or whey protein soups 30 min after dialysis initiation, followed by blood and spent dialysate sample collection. The effects on amino acid concentrations, including those of branched-chain amino acids (BCAAs), were analyzed using a mixed model for repeated measures. RESULTS: Both proteins significantly elevated BCAA concentrations compared with usual care. The effect of fish protein persisted until the end of dialysis (p = 0.016), whereas that of whey protein lasted up to 180 min after dialysis initiation (p = 0.002). Whey protein intake resulted in significantly higher amino acid levels than fish protein intake 30-90 min post-ingestion (p < 0.001), with no differences observed thereafter. CONCLUSION: Both fish and whey protein intake increased amino acid levels compared with usual care. Whey protein induced a rapid increase in levels, whereas fish protein included a slower but sustained increase in levels. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: The study protocol was registered in the UMIN Clinical Trials Registry (UMIN000050805).
Granata A, Maccarrone R, Giulio D
… +7 more, Spatola L, Granata S, Veroux M, Bellasi A, Battaglia Y, Zeiler M, Integrated Imaging and Interventional Nephrology Working Group of the Italian Society of Nephrology (SIN) and of the Italian Society for Ultrasound in Medicine and Biology (SIUMB)
Int Urol Nephrol
· 2026 Mar · PMID 41831140
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Percutaneous ultrasound-guided kidney biopsy remains the reference standard for diagnosing renal allograft dysfunction and for tailoring immunosuppression. Although major complications are uncommon in experienced hands,...Percutaneous ultrasound-guided kidney biopsy remains the reference standard for diagnosing renal allograft dysfunction and for tailoring immunosuppression. Although major complications are uncommon in experienced hands, bleeding-related events and post-biopsy vascular lesions require a rapid, operational imaging and follow-up strategy. This practical guide provides a step-by-step, competency-based workflow for renal transplant biopsy-from indication setting and risk optimisation to room set-up, equipment selection, safe cortical targeting, and specimen adequacy criteria-followed by structured post-biopsy monitoring and discharge counselling. In this study, we will be conducting a comparative analysis of percutaneous, transvenous, and CT-guided approaches. Furthermore, we will be summarising pragmatic thresholds for blood pressure, coagulation parameters, and periprocedural antithrombotic management. A dedicated section integrates contrast-enhanced ultrasound (CEUS) into complication triage when grayscale ultrasound and Doppler are equivocal, defining practical triggers for escalation and follow-up pathways for haematoma, pseudoaneurysm, arteriovenous fistula, and segmental perfusion defects. The translation of imaging findings into actionable clinical decisions, facilitated by a protocolised biopsy technique in conjunction with CEUS-driven problem solving, has been demonstrated to enhance diagnostic confidence and improve safety in routine transplant care.
Int Urol Nephrol
· 2026 Mar · PMID 41826513
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OBJECTIVES: To determine whether the MutT Homolog 1 (MTH1) inhibition could increase the sensitivity of Castration-Resistant Prostate Cancer (CRPC) cells to Radiotherapy (RT), as well as to determine the appropriate appl...OBJECTIVES: To determine whether the MutT Homolog 1 (MTH1) inhibition could increase the sensitivity of Castration-Resistant Prostate Cancer (CRPC) cells to Radiotherapy (RT), as well as to determine the appropriate application time of the MTH1 inhibitor and RT to achieve optimal radiosensitizing effects. METHODS: PC-3 and DU-145 cells were selected as the model cell lines for CRPC. After 24 h of incubation, the cells were treated with various doses of the MTH1 inhibitor TH287 for 72 h, during which they were subjected to Ionizing Radiation (IR) treatment at 12, 24, and 48 h after the initial drug treatment. Cell survival was evaluated through the Cell Counting Kit 8 (CCK-8) assay. Apoptotic induction and cell cycle progression were evaluated through Western Blotting (WB) and flow cytometry analyses. RESULTS: The CCK-8 assay revealed that the TH287 + IR combination therapy significantly inhibited PC3 and DU145 cell survival, with the most potent effects observed in the combined IR administration at 12 h (P < 0.05). Furthermore, Annexin-V/PI (Propidium Iodide) dual staining revealed that the TH287 + IR combination treatment induced apoptotic tumor cell death more effectively than either treatment alone (P < 0.05). Moreover, WB analysis revealed that the TH287 + IR combination therapy significantly altered caspase-3 expression, indicating DNA damage induction and modulation of various cell cycle-related proteins. Moreover, flow cytometry analysis revealed that the TH287 + IR treatment caused significant G2/S-phase arrest in prostate cancer cells (P < 0.05). CONCLUSION: Overall, TH287 exhibited potent radiosensitization effects for CRPC treatment, effectively killing tumor cells when administered alongside IR at 12 h after the initial drug treatment.
Ye JB, Zeng K, Li XB
… +3 more, Yang J, Zhang S, Chen Q
Int Urol Nephrol
· 2026 Mar · PMID 41817910
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OBJECTIVE: To evaluate the efficacy of fosfomycin trometamol powder (FMT) in preventing biofilm-associated bacterial infections on double-J stents in diabetic patients; to characterize the species distribution and antimi...OBJECTIVE: To evaluate the efficacy of fosfomycin trometamol powder (FMT) in preventing biofilm-associated bacterial infections on double-J stents in diabetic patients; to characterize the species distribution and antimicrobial susceptibility patterns of biofilm-forming bacteria isolated from these devices; and to identify clinical and microbiological risk factors associated with such infections-thereby informing evidence-based strategies for infection prevention in this high-risk population. METHODS: A total of 100 adult diabetic patients who underwent double-J stent placement at our tertiary care center between June 2024 and June 2025 were prospectively enrolled and randomized in a 1:1 ratio to either an experimental group or a control group (n = 50 per group). Patients in the experimental group received a single oral dose of 3 g FMT on the day before stent insertion and on postoperative days 7 and 15; those in the control group received a single oral dose of 0.5 g levofloxacin (LFX) tablets on the day before stent insertion and on postoperative days 1 and 2. At the time of stent removal, stent surface specimens were collected for quantitative biofilm-forming bacterial culture, species identification, and antimicrobial susceptibility testing. Baseline clinical characteristics, stent-related symptoms, and infection outcomes were systematically recorded. Statistical analysis was conducted using SPSS version 26.0, with two-sided p < 0.05 considered statistically significant. RESULTS: Among the 100 diabetic patients with indwelling double-J stents, biofilm-forming bacterial colonization was detected in 24 (24.0%), with significantly lower prevalence in the experimental group (7/50, 14.0%) than in the control group (17/50, 34.0%) (χ = 5.48, p = 0.019). Escherichia coli (E. coli) was the predominant pathogen isolated (accounting for 50% of all positive cultures); among these E. coli isolates, 83.3% (10/12) were confirmed as extended-spectrum β-lactamase (ESBL)-producing strains. Gram-negative bacilli exhibited high-level resistance to ciprofloxacin (93.7%), ampicillin (100%), levofloxacin (87.5%), cefepime (68.7%), cefazolin (87.5%), cefuroxime (81.2%), and ceftriaxone (75.0%). Multivariable logistic regression identified age ≥ 60 years, double-J stent indwelling duration ≥ 30 days, daily fluid intake ≤ 2000 mL, serum albumin < 30 g/L, serum creatinine > 110 μmol/L, and glycated hemoglobin (HbA1c) > 6% as independent risk factors for biofilm-associated bacterial infection (p < 0.05). CONCLUSION: When administered with equivalent dosing frequency (three doses total), FMT was associated with a significantly lower detection rate of biofilm-forming bacteria in double-J stent specimens compared with LFX among diabetic patients. These findings support the preferential use of FMT over LFX for targeted prophylaxis in high-risk diabetic populations and underscore the importance of integrating antimicrobial stewardship-particularly agent selection aligned with local resistance patterns-with proactive management of modifiable risk factors to optimize infection prevention and clinical outcomes.
Zhang H, Jiang L, Ni R
… +3 more, Qian P, Wang Z, Li W
Int Urol Nephrol
· 2026 Mar · PMID 41811624
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BACKGROUND: This study aimed to develop and validate an interpretable nomogram to predict the risk of sleep disturbance in maintenance hemodialysis (MHD) patients. METHODS: In this single-center study, 208 MHD patients w...BACKGROUND: This study aimed to develop and validate an interpretable nomogram to predict the risk of sleep disturbance in maintenance hemodialysis (MHD) patients. METHODS: In this single-center study, 208 MHD patients were enrolled. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a score > 5 defining the sleep disorder group. Univariate and multivariable logistic regression analyses identified independent predictors, which were used to construct a nomogram. The model's performance was evaluated by the area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis (DCA). Explainable AI (SHapley Additive exPlanations, SHAP) was applied to interpret the model. RESULTS: Among 208 patients, 144 (69.2%) had sleep disturbance. Multivariable analysis identified restless legs syndrome (RLS) (OR = 4.52, 95% CI: 2.22-9.18), older age (OR = 1.04, 95% CI: 1.01-1.07), lower serum albumin (Alb) (OR = 0.86, 95% CI: 0.77-0.96), and lower parathyroid hormone (PTH) (OR = 0.99, 95% CI: 0.99-0.99) as independent predictors. Primary kidney disease etiology was retained for clinical comprehensiveness. The nomogram incorporating these five predictors demonstrated good discrimination (AUC = 0.80, 95% CI: 0.73-0.86), satisfactory calibration, and positive net benefit on DCA. SHAP analysis confirmed RLS as the most influential predictor and revealed complex, non-linear relationships for Alb and PTH. CONCLUSION: This study presents a validated, interpretable nomogram that is associated with the individual risk of sleep disturbance in MHD patients using five readily available clinical parameters. The tool demonstrates good performance and clinical utility, potentially facilitating early identification and personalized management of high-risk individuals.
Baskaran G, Pinthus JH, Karampatos S
… +25 more, Ng KKH, Garcia CC, Mian R, Pyne L, Brimble S, Klotz LH, Fradet V, Selvanayagam JB, Guha A, Higano CS, Avezum Á, Hajjar LA, Cavalli GD, Valle FH, Duceppe E, Dusilek CDOL, Shayegan B, Piccoli RK, Gomez-Mesa J, Niazi T, Davis MK, Cita Pardo JE, Luke PP, Leong D, RADICAL PC Investigators
Int Urol Nephrol
· 2026 Mar · PMID 41807888
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PURPOSE: To evaluate the effect of androgen deprivation therapy (ADT) on kidney function in patients with prostate cancer (PC). METHODS: We analyzed the RADICAL-PC cohort (NCT03127631), a prospective study of patients wi...PURPOSE: To evaluate the effect of androgen deprivation therapy (ADT) on kidney function in patients with prostate cancer (PC). METHODS: We analyzed the RADICAL-PC cohort (NCT03127631), a prospective study of patients with PC in 10 countries. Patients were categorized as ADT-exposed or ADT-naïve at baseline. We quantified kidney function using estimated glomerular filtration rate (eGFR), calculated from creatinine measurements obtained at annual visits over a 2 year follow-up period. We used a linear mixed-effects regression model to analyze the association between ADT and eGFR, adjusting for covariates known to affect renal function. We assessed the association between ADT and kidney injury during hospitalization using Cox proportional-hazards regression. RESULTS: This analysis included 4 742 patients. The rate of eGFR decline over the 2 year follow-up period was greater in ADT-naïve patients (-1.322 [95% CI, -1.649 to -0.995] ml/min/1.73m/year, p < 0.001) than ADT-exposed patients (-0.706 [95% CI, -1.097 to -0.316] ml/min/1.73m/year, p < 0.001, interaction p = 0.025). Age and heart failure were associated with worsening eGFR, while higher baseline eGFR was associated with preserved eGFR. Duration of ADT use was not associated with change in eGFR (+ 0.04 [95% CI, -0.03 to + 0.10] ml/min/1.73m/year per month of ADT use, p = 0.260). Kidney injury during hospitalization occurred in 135 (2.8%) patients, with no significant association with ADT (HR 1.37 [95% CI, 0.91 to 2.07], p = 0.135). CONCLUSION: This analysis suggests that eGFR declines more modestly in patients initiating ADT than ADT-naïve patients. These findings do not preclude true kidney function decline due to ADT-mediated reduction in creatinine generation, and warrant further investigation.
Panunzio A, Lujan S, Piccinni B
… +4 more, Greco F, D'Elia SD, Rizzo FL, Tafuri A
Int Urol Nephrol
· 2026 Mar · PMID 41806242
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PURPOSE: Retinoic acid is essential for spermatogonial differentiation and meiotic initiation, providing a biologically plausible rationale for exploring retinoid-based therapies in the context of male infertility. Isotr...PURPOSE: Retinoic acid is essential for spermatogonial differentiation and meiotic initiation, providing a biologically plausible rationale for exploring retinoid-based therapies in the context of male infertility. Isotretinoin is widely prescribed for acne. However, it has historically raised concerns about potential sexual adverse effects. We aim to synthesize contemporary available clinical evidence on isotretinoin and clarify whether it poses reproductive risks or may hold any potential therapeutic relevance in men across both dermatologic and infertility settings. METHODS: Following PRISMA guidelines, we systematically searched MEDLINE/PubMed, Scopus, and Web of Science from inception to November 2025 for original articles investigating the effects of isotretinoin on semen parameters, reproductive hormones, sexual function, or fertility outcomes. A narrative synthesis was conducted in conjunction with a random-effects meta-analysis for semen parameters when means and standard deviations were available. RESULTS: Six clinical studies involving 225 men were included: three dermatologic cohorts (n = 167) with normal baseline fertility, treated with standard isotretinoin regimens for acne, and three infertility cohorts (n = 58), receiving low-dose isotretinoin for oligoasthenozoospermia, cryptozoospermia, or non-obstructive azoospermia. In dermatologic populations, random-effects meta-analysis showed small but statistically significant increases in sperm concentration (Mean Difference [MD] + 1.77 million/mL, p = 0.028) and vitality (MD + 3.74%, p = 0.009), with non-significant positive trends for progressive motility (MD + 4.12%) and normal morphology (MD + 1.13%). In infertility settings, sperm concentration increased by approximately + 1.3 million/mL, progressive motility improved by + 3%, and normal morphology remained stable in oligoasthenozoospermic men. In comparison, de novo sperm appeared in 37-44% of azoospermic or cryptozoospermic men, enabling pregnancies across three studies (both spontaneous and with assisted reproductive technology). No study reported impaired fertility or treatment-emergent sexual dysfunction. Overall, the certainty of evidence was low to moderate. CONCLUSION: Current clinical data do not support reproductive harm from isotretinoin. Instead, isotretinoin may enhance semen quality in healthy men and promote clinically meaningful spermatogenic recovery in selected infertility contexts. Controlled trials are needed to define therapeutic efficacy, identify responders, and clarify its role in male infertility management.
Peñaherrera-Vásquez D, Reina A, Merlo F
… +4 more, Fajardo-Loaiza T, Zambrano-Sánchez G, Rivadeneira J, Fuenmayor-González L
Int Urol Nephrol
· 2026 Mar · PMID 41796425
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IMPORTANCE: Long COVID has been associated with persistent multisystemic manifestations. However, genitourinary alterations have not been formally recognized as a distinct phenotype despite growing reports suggesting the...IMPORTANCE: Long COVID has been associated with persistent multisystemic manifestations. However, genitourinary alterations have not been formally recognized as a distinct phenotype despite growing reports suggesting their relevance for long-term morbidity and quality of life. OBJECTIVES: To determine the frequency and characteristics of genitourinary manifestations in patients with long COVID and to evaluate the evidence supporting the possible emergence of a genitourinary phenotype within long COVID. DATA SOURCES: For this Systematic review and meta-analysis, a comprehensive search was conducted in PubMed (MEDLINE), Scopus, Web of Science, Embase, SciELO, and Bireme-BvS from inception to October 2025, without language or publication date restrictions. Observational studies (cross-sectional, cohort, or case-control) assessing individuals with one or more genitourinary symptoms-such as menstrual alterations, erectile dysfunction, urinary tract symptoms, or renal function decline-persisting ≥ 12 weeks after SARS-CoV-2 infection were included. Studies addressing only acute-phase manifestations, vaccine-related effects, or pre-existing genitourinary conditions were excluded. DATA EXTRACTION AND SYNTHESIS: Data extraction was performed independently by two reviewers following PRISMA guidelines. Risk of bias (RoB) was assessed using the Joanna Briggs Institute checklist for prevalence studies. A random-effects meta-analysis using the Freeman-Tukey double arcsine transformation was applied to estimate pooled proportions, and heterogeneity was quantified using the I statistic, Cochran's Q test, and the between-study variance (τ). MAIN OUTCOMES AND MEASURES: The primary outcomes were the pooled frequencies of genitourinary manifestations in long COVID, including menstrual disorders, erectile dysfunction, and renal function decline. RESULTS: Nine primary studies encompassing 2332 participants from eight countries were included. Most studies (88.9%) presented a low RoB. The pooled frequency of menstrual disorders was 49% (95% CI 24-74), erectile dysfunction 21% (95% CI 16-28), and renal function decline 29% (95% CI 20-39). CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis provide evidence supporting the possible emergence of a genitourinary phenotype of long COVID, encompassing menstrual irregularities, erectile dysfunction, cystitis-like symptoms, and renal impairment. Recognition of this potential phenotype is crucial for improving diagnostic accuracy, patient follow-up, and multidisciplinary management. Further high-quality studies are warranted to elucidate the underlying mechanisms and long-term clinical implications.
Int Urol Nephrol
· 2026 Mar · PMID 41795761
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Bladder cancer organoids (BCOs) represent a sophisticated three-dimensional pathological model that faithfully recapitulates the tissue architecture and molecular subtypes of parental tumors, thereby serving as a robust...Bladder cancer organoids (BCOs) represent a sophisticated three-dimensional pathological model that faithfully recapitulates the tissue architecture and molecular subtypes of parental tumors, thereby serving as a robust platform for investigating tumor heterogeneity and phenotypic plasticity. By establishing a functional bridge between pathological features and drug responses, BCOs not only enhance traditional morphological diagnoses but also predict patients' responses to chemotherapy, targeted therapy, and immunotherapy, thereby guiding individualized treatment strategies. Although BCO models face limitations such as culture bias and the absence of tumor microenvironment, which may impact accuracy, emerging technologies like assembloids and organ-on-a-chip systems are transforming patient-derived tumors from static morphological analysis to an integrated "dynamic pathology". This evolution ultimately advances precision oncology in bladder cancer.
Loon J, Li MH, Mehta S
… +6 more, Ortiz J, Monrroy M, Salman L, Koizumi N, Faddoul G, N3C Consortium
Int Urol Nephrol
· 2026 Mar · PMID 41795760
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PURPOSE: Nephrectomy can lead to hyperfiltration, focal segmental glomerulosclerosis (FSGS) and end-stage kidney disease (ESKD). We hypothesize that medications decreasing intraglomerular pressure have a positive impact...PURPOSE: Nephrectomy can lead to hyperfiltration, focal segmental glomerulosclerosis (FSGS) and end-stage kidney disease (ESKD). We hypothesize that medications decreasing intraglomerular pressure have a positive impact on glomerular filtration among other outcomes after unilateral nephrectomy. The study investigated the possible impact of the SARS-CoV2 infection known as COVID-19 on outcomes among the unilateral nephrectomy recipients. METHODS: National Clinical Cohort Collaborative (N3C) database COVID19 Enclave was analyzed using multivariable linear regression and specific outcomes of eGFR values up to 3 years post-nephrectomy, occurrence of ESKD, HTN, FSGS, and gout. RESULTS: In the non-COVID19 group, use of ACEi or ARB alone associated with a decrease in eGFR between 1 and 3 years (- 2.71 95% [- 3.90 to - 1.52]; p < 0.001), use of SGLT2i alone correlated with an increase (Coef 5.04 95% [0.781-9.301]; p = 0.02) while the concomitant use of ACEi or ARB with SGLT2i was not related to a variation in eGFR. These associations were not observed in the COVID19 group. COVID19 infection associated with an increased risk of post-nephrectomy ESKD development (HR 1.309 95% [1.066, 1.607]; p = 0.01), FSGS (HR 6.952 95% [2.685, 18.00]; p < 0.001) and gout (HR 1.411 95% [1.043, 1.907]; p = 0.025). CONCLUSION: RAS blockade did not demonstrate any significant impact on the incidence of FSGS. The analysis was limited due to the absence of patients with both SGLT2i use and FSGS. SGLT2 inhibition correlated with an overall beneficial effect on the eGFR trend post-nephrectomy.
Int Urol Nephrol
· 2026 Mar · PMID 41790419
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OBJECTIVE: To evaluate the feasibility and safety of omitting postoperative urinary catheter placement in patients undergoing percutaneous nephrolithotomy (PCNL) under paravertebral block (PVB) anesthesia without retrogr...OBJECTIVE: To evaluate the feasibility and safety of omitting postoperative urinary catheter placement in patients undergoing percutaneous nephrolithotomy (PCNL) under paravertebral block (PVB) anesthesia without retrograde catheterization. METHODS: This retrospective study analyzed 197 eligible patients selected from an initial cohort of 248. All patients received PCNL under PVB. They were divided into two groups based on postoperative catheterization: Group 1 (without urinary catheter, n = 97) and Group 2 (with urinary catheter, n = 100). To minimize confounding factors, propensity score matching was performed based on the number of access tracts, resulting in two groups: Group A (without urinary catheter, n = 90) and Group B (with urinary catheter, n = 90). Preoperative baseline characteristics, perioperative parameters, and postoperative complications were compared between the groups. RESULTS: No significant differences were observed in age, gender, body mass index (BMI), comorbidities, stone characteristics, or preoperative laboratory findings between the two groups (P > 0.05), indicating comparability. Regarding surgical efficacy and safety, there were no statistically significant differences in operative time, blood loss, number of access tracts, postoperative hemoglobin drop, inflammatory marker changes, or initial stone-free rate (P > 0.05). Group A showed superior outcomes in several aspects: lower visual analog scale (VAS) pain scores (P < 0.001), shorter postoperative hospital stay [3.00 (3.00, 4.00) vs. 4.00 (3.00, 4.00) days, P < 0.001], lower incidence of postoperative urinary tract infection (2/90 vs. 10/90, P = 0.017), and lower overall postoperative complication rate (9/90 vs. 25/90, P < 0.002). CONCLUSION: For appropriately selected patients undergoing PCNL under PVB without retrograde catheterization, omitting the postoperative urinary catheter is a safe practice. This approach is associated with reduced postoperative pain, shorter hospitalization, and merits clinical consideration under standardized perioperative management.