Urology[JOURNAL]
Sun
200 papers
Age-related differences in bladder function and sexual outcomes following bipolar transurethral resection of the prostate: a retrospective cohort study.
Yeni S, Demir A, Sabuncu H … +2 more , Yildiz HE, Ortac H
Ther Adv Urol · 2026 · PMID 42221685 · Full text
BACKGROUND: Benign prostatic obstruction negatively affects bladder emptying and, if untreated, may be associated with impaired bladder emptying and related complications. OBJECTIVES: To compare postoperative outcomes of...
BACKGROUND: Benign prostatic obstruction negatively affects bladder emptying and, if untreated, may be associated with impaired bladder emptying and related complications. OBJECTIVES: To compare postoperative outcomes of bipolar transurethral resection of the prostate (bipolar TURP) among different age groups and evaluate the effect of patient age. DESIGN: Retrospective cohort study. METHODS: We analyzed 132 male patients who underwent bipolar TURP between May 2022 and January 2024. Patients were grouped by age: Group 1 (50-60 years), Group 2 (61-70 years), and Group 3 (⩾71 years). Pre- and postoperative parameters-including prostate-specific antigen, prostate volume, uroflowmetry (maximum and average flow rates, voided volume, post-void residual), symptom duration, medication use, and International Index of Erectile Function-5 (IIEF-5) scores-were assessed at 12 months postoperatively. RESULTS: Group 1 demonstrated significantly greater improvements in peak flow rates, post-void residual volume, and IIEF-5 scores compared with the older cohorts ( < 0.05). While Group 3 presented with the longest symptom duration and highest medication use at baseline, multivariate regression analysis identified advancing age as an independent predictor of more limited improvement in post-void residual volume ( = 0.008) and IIEF-5 scores ( < 0.001), while its association with ∆max reached only marginal significance ( = 0.050). Younger patients exhibited better postoperative preservation of erectile function and relatively improved recovery of bladder emptying. CONCLUSION: Patient age is associated with urinary and sexual outcomes after bipolar TURP. The strongest age-related associations were observed for postoperative recovery of bladder emptying and preservation of erectile function, whereas improvement in peak flow rate was less strongly age-dependent and should be interpreted with caution. TRIAL REGISTRATION: Not applicable.
Editorial comment on "Post Vasectomy Semen Analysis Completion in Clinic-Based Versus Mail-In Testing".
Clark JY, Labrecque M
Urology · 2026 May · PMID 42218920 · Publisher ↗
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Editorial Comment on "Pathologic Differences in Adult Acquired Buried Penis Patients by Exhumable Status".
Hertz A
Urology · 2026 May · PMID 42218919 · Publisher ↗
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Renal Ewing Sarcoma Presenting as a Renal Cell Carcinoma Mimic With Renal Vein Tumor Thrombus.
Xue DH, Thirumala SD, Owen RC
Urology · 2026 May · PMID 42218918 · Publisher ↗
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Prospective comparative validation of a novel endoscopy chair and endoscope manipulation apparatus (EasyFlex) for ergonomic improvement in fURS procedures.
Toksoz S, Asik A, Kizilkan Y … +4 more , Senel S, Koseoglu B, Erdogan E, Sarica K
BMC Urol · 2026 May · PMID 42216216 · Full text
BACKGROUND: This study aimed to validate the functionality and usability of a doctor's endoscopy chair and an endoscope carrying/manipulation apparatus known as the EasyFlex. METHODS: Prototype models of the EasyFlex app...
BACKGROUND: This study aimed to validate the functionality and usability of a doctor's endoscopy chair and an endoscope carrying/manipulation apparatus known as the EasyFlex. METHODS: Prototype models of the EasyFlex apparatus were evaluated by five expert urologists specializing in endourology at three medical centers. The surgical and ergonomic advantages of the doctor's endoscopy chair and the endoscope carrying/manipulation apparatus were compared with those used during traditional flexible ureterorenoscopy (fURS) procedures for kidney stones, with ergonomic outcomes assessed using the Ergomini scale. RESULTS: The ergonomic evaluation of both systems revealed that surgeons experienced significantly greater ergonomic discomfort during traditional fURS procedures compared to those using the EasyFlex system, as indicated by higher total ergonomic scores (37.6 vs. 12.6, p < 0.001). Furthermore, the EasyFlex group demonstrated a significantly lower rate of intraoperative complications than the traditional fURS group (11.8% vs. 27%, p = 0.017). CONCLUSION: Compared with the traditional approach, the results obtained in our study demonstrated that the EasyFlex apparatus could provide superior ergonomic conditions during fURS procedures. Additionally, the rate of intraoperative complications was lower in the EasyFlex group.
The impact of preoperative CT-based 3D visualization model on ureteric access sheath placement failure without pre-stenting.
Zhang Y, Hu C, Li H
BMC Urol · 2026 May · PMID 42216161 · Full text
BACKGROUND: Placement failure of the flexible and navigable suction ureteral access sheath (FANS) with negative pressure suction may occur during retrograde intrarenal surgery (RIRS) due to ureteral stricture, hemorrhage...
BACKGROUND: Placement failure of the flexible and navigable suction ureteral access sheath (FANS) with negative pressure suction may occur during retrograde intrarenal surgery (RIRS) due to ureteral stricture, hemorrhage, injury and other factors. This study aimed to investigate the predictive value of parameters from a 3D visualization model based on preoperative computed tomography (CT) for the failure of FANS placement without pre-stenting. METHODS: We retrospectively analyzed the clinical data of 113 patients who underwent RIRS at Chengdu Hospital of Integrated Traditional Chinese and Western Medicine. A 3D visualization model was constructed based on preoperative CT data to measure the lateral ureteral angle, intramural ureteral diameter, intramural ureteral length and pelvic ureteral diameter. A predictive model for failure of FANS placement without pre-stenting was established after univariate and multivariate analyses, and the model performance was evaluated by bootstrap internal validation, calibration curves, decision curve analysis (DCA) etc. RESULTS: Among the 113 patients, significant intergroup differences were observed between the successful placement group (n = 96) and the failed placement group (n = 17) in age (P = 0.010), lateral ureteral angle (P = 0.018), intramural ureteral diameter (P < 0.001) and pelvic ureteral diameter (P = 0.008). No significant intergroup differences were found in body mass index (BMI), stone CT value, stone size, stone number, gender, hydronephrosis, history of ipsilateral lithotripsy, preoperative fever history or intramural ureteral length (P > 0.05). Multivariate analysis identified intramural ureteral diameter (OR = 0.06, 95% CI: 0.01~ 0.29, P < 0.001) and pelvic ureteral diameter (OR = 0.26, 95% CI: 0.08 ~ 0.78, P = 0.017) as protective factors against placement failure, while the lateral ureteral angle (OR = 1.17, 95% CI: 1.04 ~ 1.31, P = 0.006) was a risk factor for placement failure. Due to sample size limitations, the lateral ureteral angle and intramural ureteral diameter were included in the predictive model based on the Bayesian information criterion (BIC). The area under the curve (AUC) of the model was 0.852 (95% CI: 0.763 ~ 0.941), and the AUC of internal validation via Bootstrap resampling (n = 1000) was 0.846 (95% CI: 0.808 ~ 0.860). CONCLUSIONS: The intramural ureteral diameter and lateral ureteral angle measured by the 3D visualization model based on preoperative CT are powerful predictors for the failure of FANS placement without pre-stenting. The constructed predictive model exhibits good performance. However, further validation with multi-center and large-sample studies is still required.
Massive bleeding from a Bricker ileal conduit during FOLFIRINOX therapy in noncirrhotic portal hypertension: suspected oxaliplatin-associated sinusoidal injury and presumed irinotecan-associated conduit mucositis: a case report.
Drobot RB, Ślósarz T, Antoniewicz AA
BMC Urol · 2026 May · PMID 42215991 · Full text
BACKGROUND: Bleeding from an ileal conduit after radical cystectomy is uncommon and is usually attributed to tumor recurrence, infection, stones, or local stomal trauma. Portal hypertensive stomal varices are rare. FOLFI...
BACKGROUND: Bleeding from an ileal conduit after radical cystectomy is uncommon and is usually attributed to tumor recurrence, infection, stones, or local stomal trauma. Portal hypertensive stomal varices are rare. FOLFIRINOX adds further diagnostic complexity because oxaliplatin may cause sinusoidal endothelial injury and noncirrhotic portal hypertension, whereas irinotecan may damage gastrointestinal mucosa. We report a case of massive hemorrhage from a long-functioning Bricker ileal conduit during FOLFIRINOX therapy. CASE PRESENTATION: A 72-year-old man with prior radical cystoprostatectomy with Bricker diversion in 2022, robot-assisted left adrenalectomy in 2023, and pancreatic head adenocarcinoma treated with FOLFIRINOX was admitted in February 2026 because of sudden gross hematuria that rapidly filled the urostomy bag with blood and clot. He had received two FOLFIRINOX cycles. With a height of 170 cm and weight of 70 kg, body-surface area was 1.82 m² by the Mosteller formula. Using the standard FOLFIRINOX oxaliplatin dose of 85 mg/m², the reconstructed cumulative oxaliplatin exposure was approximately 170 mg/m², corresponding to about 310 mg in total. Bleeding began 8 days after the most recent irinotecan-containing cycle. Contrast-enhanced computed tomography showed periportal tumor-related changes with a biliary stent, variceal collaterals adjacent to the conduit, and circumferential thickening of the conduit wall, whereas the upper urinary tracts were nondilated and there was no radiologic evidence of recurrent urothelial carcinoma. Looposcopy demonstrated diffusely inflamed and friable conduit mucosa, but biopsy was not performed. Doppler ultrasonography demonstrated portal vein dilatation with preserved hepatopetal flow and no imaging features of cirrhosis. Platelet counts remained within the reference range, and retrospective review of restaging computed tomography showed no interval splenomegaly; the craniocaudal splenic length was approximately 11 cm and unchanged. Urine culture grew extended-spectrum beta-lactamase-producing Escherichia coli and Enterococcus faecalis, but inflammatory markers remained low and there were no clinical features of sepsis. The most cautious interpretation was a mixed mechanism: portal hypertensive stomal varices, possibly related to pancreatic venous distortion and/or early oxaliplatin-associated sinusoidal injury, compounded by presumed irinotecan-associated conduit mucositis. Bleeding ceased with supportive, anti-inflammatory, antimicrobial, transfusion, and nonselective beta-blocker therapy. By May 2026, conduit bleeding had not recurred, although the patient remained chronically unwell with poor ECOG performance status because of the underlying pancreatic cancer. CONCLUSIONS: Massive bleeding from a Bricker conduit during FOLFIRINOX therapy may be multifactorial. Early portal-phase imaging and portal venous assessment are essential when hemorrhage is disproportionate to routine urinary tract findings. In the absence of histology, catheter venography, and portal pressure measurement, causal language should remain cautious. If bleeding recurs, management should move beyond local measures and consider venous mapping, targeted embolization or sclerotherapy, portal decompression or venous stenting in suitable anatomy, and surgical undiversion to bilateral cutaneous ureterostomies when durable conduit preservation appears unlikely.
Correction: Efficacy and safety of mirabegron versus solifenacin in the treatment of overactive bladder in children: a systematic review and meta-analysis.
Shaheen M, Ali OM, Draz AA … +10 more , Barakat AK, Elghattas A, Elbaz T, Walid I, Tarboush T, Elsayed A, Mahmoud T, Elkhateeb EM, Nofal AA, Samaan E
BMC Urol · 2026 May · PMID 42215984 · Full text
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Association between hepatitis C virus and overactive bladder: a cross-sectional study based on the 2013-2018 NHANES.
Ding Y, Zhao T, Ji J … +6 more , Wang Z, Zhang D, Ye Z, Chen M, Mao W, Wu J
BMC Urol · 2026 May · PMID 42215955 · Full text
BACKGROUNDS: Overactive bladder (OAB) is a common urological disorder with an incompletely understood pathogenesis that markedly impacts patients' quality of life, and hepatitis C virus (HCV) infection is associated with...
BACKGROUNDS: Overactive bladder (OAB) is a common urological disorder with an incompletely understood pathogenesis that markedly impacts patients' quality of life, and hepatitis C virus (HCV) infection is associated with systemic inflammation and extrahepatic complications, with their potential association remaining understudied. This study thus aims to investigate the association between HCV and OAB in adults. This study aims to investigate the association between hepatitis C virus (HCV) and overactive bladder (OAB) in adults. METHODS: This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2018. Logistic regression analysis, subgroup analysis, and interaction tests were employed to assess the association between HCV and OAB. Additionally, propensity score matching (PSM), inverse probability weighting (IPTW), and overlap weighting (OW) were employed to control for confounding factors. E-value analysis was conducted to assess the robustness of results against unmeasured confounders, while sensitivity and specificity analyses evaluated the predictive performance of HCV for OAB. RESULTS: This study included 14,012 patients aged ≥ 20 years. Logistic regression analysis demonstrated an association between HCV and OAB (OR = 2.06, 95% CI 1.46-2.90, p < 0.001). Subgroup analyses and interaction tests confirmed that the relationship between HCV and OAB remained consistent across all subgroups (all interaction P values > 0.05). After PSM, IPTW, and OW analyses, the association between the two remained significant; E-value analysis demonstrated strong robustness to unmeasured confounders; Sensitivity and specificity results indicate that HCV has predictive value for OAB. CONCLUSIONS: The findings of this study indicate that there is a significant correlation between HCV and OAB.
CT and MRI features of renal inflammatory myofibroblastic tumor and its differential diagnosis from clear cell renal cell carcinoma and chromophobe renal cell carcinoma: a study of 13 cases from two centers.
Du H, Wu J, Shen Q … +6 more , Rong C, Wang K, Liu J, Qiu J, Wang H, Qin N
BMC Urol · 2026 May · PMID 42210207 · Full text
BACKGROUND: To compare the CT and MRI features of renal inflammatory myofibroblastic tumor (IMT) with those of clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (ChRCC). METHODS: Clinical and i...
BACKGROUND: To compare the CT and MRI features of renal inflammatory myofibroblastic tumor (IMT) with those of clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (ChRCC). METHODS: Clinical and imaging data of 13 patients with pathologically confirmed renal IMT, along with 52 patients with ccRCC and 52 with ChRCC treated at two centers between January 2013 and February 2025 were retrospectively obtained, and the lesions' location, shape, margin, size, secondary changes, density or signal characteristics, and enhancement degree with pattern were analyzed. The clear cell likelihood score (ccLS) was used for the evaluation of MRI characteristics. RESULTS: The renal IMT cohort comprised 9 males and 4 females (mean age, 54.2 ± 8.61 years). All lesions were solitary, measuring 1.7-14.4 cm. Notably, ill-defined margins were detected in 9/13 (69.2%), perirenal fascia thickening in 8/13 (61.5%), and non-enhancing region in 3/13 (23.1%). There was no hemorrhage, central scar or calcification. Unenhanced CT showed a mean attenuation of 43.7 HU. On contrast-enhanced CT, 77.8% (7/9) exhibited mild-moderate enhancement, with 55.6% (5/9) showing progressive enhancement and 33.3% (3/9) demonstrating a "slow-in and slow-out" pattern. MRI revealed hypointense or isointense signal on T1WI and T2WI, while 87.5% (7/8) showed restricted diffusion on DWI and arterial-to-delayed enhancement ratio < 1.5. No lesions exhibited microscopic fat or segmental enhancement inversion. The ccLS for renal IMTs were predominantly 1-2. Compared to ccRCCs and ChRCCs, renal IMTs more commonly exhibited ill-defined margins (P1 = 0.037, P2 < 0.001), perirenal fascia thickening (P1 = 0.014, P2 < 0.001) and higher unenhanced CT attenuation (P1 = 0.016, P2 = 0.030). Two renal IMT cases showed suspected postoperative recurrence or metastasis. CONCLUSIONS: CT and MRI imaging features can facilitate the diagnosis of renal IMT and differentiate it from ccRCC and ChRCC.
Single-cell and spatial RNA sequencing in prostate cancer.
Ali A, Mikutenaite M, Weischenfeldt J … +1 more , Bristow RG
Nat Rev Urol · 2026 May · PMID 42209670 · Publisher ↗
Single-cell RNA sequencing (scRNA-seq) has become an indispensable tool in prostate biology research, considerably advancing our understanding from organ development to disease initiation and progression. This technology...
Single-cell RNA sequencing (scRNA-seq) has become an indispensable tool in prostate biology research, considerably advancing our understanding from organ development to disease initiation and progression. This technology has provided profound insights into prostate disease, from benign prostatic hyperplasia to metastatic prostate cancer, particularly with respect to the tumour microenvironment, cellular lineage plasticity and resistance to androgen receptor-dependent therapies. scRNA-seq has revealed complex and potentially targetable interactions between epithelial, stromal and immune subtypes driving disease heterogeneity. As a complementary technology, spatial transcriptomics enables the characterization of tumour architecture using spatial resolution at the single-cell or multi-cell level. Importantly, these approaches also permit bioinformatic inference of large-scale copy number variants, enabling integrated genomic-transcriptomic analysis of clonal evolution and therapy resistance. Understanding the biological consequences of this heterogeneity could support patient sub-stratification, biomarker development and therapeutic strategies targeting genomic instability or tumour microenvironment interactions.
Clinical and imaging predictors of urachal carcinoma: the role of gross hematuria and calcification in a single-center retrospective study.
Thai KL, Le PND, Nguyen TT … +1 more , Ngo XT
BMC Urol · 2026 May · PMID 42204692 · Full text
BACKGROUND: Urachal anomalies are rare entities in the adult population with significant malignant potential. This study aims to comprehensively describe clinical and paraclinical characteristics, as well as to analyze a...
BACKGROUND: Urachal anomalies are rare entities in the adult population with significant malignant potential. This study aims to comprehensively describe clinical and paraclinical characteristics, as well as to analyze and evaluate prognostic factors for urachal carcinoma, thereby facilitating early diagnosis and effective management. METHODS: We conducted a retrospective study on patients diagnosed with urachal anomalies from 2017 to 2025. Data regarding clinical characteristics, imaging findings, treatment modalities, and clinical outcomes were collected for both benign and malignant cases. Additionally, survival outcomes were specifically analyzed for patients with urachal carcinoma. RESULTS: A total of 112 patients were included, comprising 8.9% cases of urachal carcinoma, while infection was the predominant presentation (72.3%). Surgical management differed significantly by pathology, with urachal excision and partial cystectomy performed in 80.0% of malignant cases versus 23.9% of benign cases. Multivariate logistic regression identified hematuria (Odds Ratio (OR) 14.1; 95% Confidence Interval (CI) 1.3-153.6; p = 0.03) and calcification (OR 13.5; 95% CI 1.7-109.2; p = 0.01) as significant independent predictors of malignancy. Histologically, adenocarcinoma was the major subtype (80%), with most tumors being Sheldon stage IIIA or IV. Overall survival (OS) showed a steep decline, recorded at 90.0%, 60.0%, and 15.0% at 1, 3, and 5 years, respectively. CONCLUSIONS: Gross hematuria and calcification serve as critical, independent predictors of urachal malignancy. Given the aggressive nature and poor overall prognosis (5-year OS of only 15.0%), the presence of these indicators necessitates an aggressive diagnostic workup and prompt radical surgical intervention (en-bloc urachal excision with partial cystectomy) to optimize long-term patient outcomes.
Publisher Correction: HER2 in urothelial cancer: clinical speed outpacing diagnostic clarity.
Crupi E, Pederzoli F, Huddart RA … +2 more , Cheng L, Raggi D
Nat Rev Urol · 2026 May · PMID 42204282 · Publisher ↗
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Symptoms and subtypes of patients with lower urinary tract dysfunction - insights from the Symptoms of Lower Urinary Tract Dysfunction Research Network.
Yang CC, Kirkali Z, Cameron AP … +11 more , Lai HH, Cella D, Andreev VP, Kreder KJ, Bradley CS, Helfand BT, Clemens JQ, Amundsen CL, Smith AR, Weinfurt KP, Symptoms of Lower Urinary Tract Dysfunction Research Network
Nat Rev Urol · 2026 May · PMID 42204281 · Publisher ↗
Lower urinary tract dysfunction presents with a wide range of bothersome urinary symptoms, which are common in both men and women, with incidence and prevalence increasing with age. Individuals with lower urinary tract s...
Lower urinary tract dysfunction presents with a wide range of bothersome urinary symptoms, which are common in both men and women, with incidence and prevalence increasing with age. Individuals with lower urinary tract symptoms (LUTS) suffer from the chronicity of their symptoms, have a reduced quality of life, and experience high morbidity with associated medical conditions. Various treatment options exist, but many patients do not find satisfactory or lasting relief. The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) was formed in 2012 with the goals of improving methods for assessing patient-reported experiences with LUTS; identifying and describing patient subtypes; and generating data, research tools and biological samples for future studies. LURN developed three self-report instruments for measuring LUTS. More than 1,000 men and women with LUTS seeking treatment were enrolled, and completed a baseline and interval assessments throughout a 12-month observational period. Findings from LURN studies showed that various biological, non-urological, psychosocial and behavioural factors contribute to the development and persistence of LUTS. Additionally, patients seeking care for LUTS often present with a wider variety of urological symptoms than previously thought. Diagnoses for these patients do not reliably fit into traditional categories such as overactive bladder or BPH. LURN has addressed its objectives by creating new, top-tier assessment tools; conducting studies to gather clinically relevant data to identify potential new and accurate patient subtypes; and collecting a wealth of data and biological samples for future research to continue subtype refinement.
Overcoming surgical challenges with robotic assistance: robot-assisted nephrectomy of a failed renal allograft after complex en-bloc dual kidney transplantation.
Yang X, Zhang Z, Shi W … +5 more , Zhu H, Zhang W, Zhang S, Zhang Q, Hou X
BMC Urol · 2026 May · PMID 42192503 · Full text
We present the case of a 37-year-old male who underwent infant donor en-bloc dual kidney transplantation (EBKT) and subsequently developed left allograft failure with severe refractory urinary tract infection secondary t...
We present the case of a 37-year-old male who underwent infant donor en-bloc dual kidney transplantation (EBKT) and subsequently developed left allograft failure with severe refractory urinary tract infection secondary to long-standing ureteropelvic junction obstruction and hydronephrosis. After failure of conservative anti-infective therapy to control recurrent infection, the patient underwent successful robot-assisted extracapsular allograft nephrectomy (ECAN), with the primary surgical indication of eradicating the source of refractory infection in the obstructed, completely non-functional allograft. The procedure was completed in 145 min with minimal blood loss (20 mL). The patient was discharged on postoperative day 5 with complete resolution of symptoms and preserved function of the contralateral viable graft. This case demonstrates that robot-assisted surgery offers a safe and precise surgical option for failed allograft nephrectomy after complex pediatric EBKT, with favorable perioperative outcomes in this specific scenario involving distorted anatomy and severe adhesions.
Aggressive chronic prostatitis mimicking locally advanced prostate cancer with apparent extraprostatic extension: a case report.
Ozdemir O
BMC Urol · 2026 May · PMID 42192391 · Full text
BACKGROUND: Multiparametric prostate MRI (mpMRI) is widely used for prostate cancer detection and local staging. Imaging features such as marked diffusion restriction, intense contrast enhancement, and apparent extrapros...
BACKGROUND: Multiparametric prostate MRI (mpMRI) is widely used for prostate cancer detection and local staging. Imaging features such as marked diffusion restriction, intense contrast enhancement, and apparent extraprostatic extension are typically associated with aggressive malignancy. However, inflammatory conditions may rarely mimic locally advanced prostate cancer, potentially leading to overstaging and inappropriate treatment. CASE PRESENTATION: A 49-year-old man presented with nonspecific lower urinary tract symptoms and a serum prostate-specific antigen level of 2.7 ng/mL. mpMRI revealed a large mass-like peripheral zone lesion with marked diffusion restriction, rapid early enhancement, and imaging features suggestive of extraprostatic extension, leading to a PI-RADS 5 assessment and suspicion of locally advanced prostate cancer. Despite aggressive imaging findings, systematic biopsy demonstrated chronic prostatitis without malignancy. Following antibiotic therapy, short-term follow-up mpMRI showed marked regression of the lesion with resolution of diffusion restriction and contrast enhancement, confirming an inflammatory etiology. CONCLUSIONS: Aggressive chronic prostatitis may closely mimic locally advanced prostate cancer on mpMRI, including apparent extraprostatic extension. Recognition of this diagnostic pitfall and careful radiologic-clinical correlation are essential to avoid overstaging and unnecessary definitive treatment.
Could miRNAs be used as markers for distinguishing undescended testes from retractile testes? A prospective controlled pilot/exploratory study.
Keleş M, Benli E, Ergün S … +6 more , Çırakoğlu A, Yazıcı İ, Kadim N, Noyan T, Demir D, Sılay MS
BMC Urol · 2026 May · PMID 42192354 · Full text
BACKGROUND: Undescended testes (UDTs) are common in male infants. Untreated UDT poses risks such as infertility (IF), testicular cancer (TC), and testicular torsion (TT). Retractile testes (RTs) sporadically ascend from...
BACKGROUND: Undescended testes (UDTs) are common in male infants. Untreated UDT poses risks such as infertility (IF), testicular cancer (TC), and testicular torsion (TT). Retractile testes (RTs) sporadically ascend from the scrotum. UDT requires early surgical correction, whereas RT requires only periodic follow-up. Differentiating these conditions is challenging, making clinical biomarkers potentially useful. The aim of our study was to examine the use of miRNAs as biomarkers in the differential diagnosis of UDT and RT which are difficult to differentiate. METHODS: This prospective pilot/exploratory study included 10 boys with UDT (operated), 9 with RT (followed), and 9 controls. Only palpable (unilateral or bilateral) UDT cases were included, excluding nonpalpable types. To ensure accurate RT diagnosis, initial physician examinations were performed in three positions (supine, semi-supine, standing), followed by a 1-month parental examination (twice daily). Only RT patients whose testes spent > 50% of their time in the scrotum were included. The exclusion criteria also included prior inguinal/scrotal surgery, defective datasets, or unsuitable serum samples. Parent consent and serum samples were collected to evaluate miR-210, miR-34c, and miR-449a expression via real-time PCR. RESULTS: Statistical analysis revealed no significant difference in miR-34c (p = 0.157) or miR-210 (p = 0.950) expression. However, the miR-449a level differed significantly between the groups (p = 0.033). Dunn-Bonferroni post hoc correction revealed significantly greater miR-449a in the RT group than in the UDT group (p < 0.05). No difference in miR-449a expression was found between the control and UDT groups (p > 0.05). Serum miR-449a demonstrated significant diagnostic potential in differentiating UDT from retractile testis (AUC: 0.822, p = 0.017) with 90.0% sensitivity and 77.8% specificity. These findings suggest that miR-449a could serve as a promising non-invasive biomarker to distinguish true undescended testis from its clinical mimics. CONCLUSIONS: Serum miRNA levels represent a potential tool for differentiating UDT from RT. Our pilot/exploratory study partially corroborates this, but comprehensive prospective randomized trials with larger cohorts are essential to definitively clarify miRNA alterations for precise distinction. TRIAL REGISTRATION: This prospective case-control study was registered to clinicaltrials.gov database, 'retrospectively'. The trial registration number is: NCT07315737, the unique protocol ID is: 2022/25.
Lack of real-world evidence on active surveillance in Chinese patients with prostate cancer: insights from a 10-year cohort and a physician survey.
Xian P, Li P, Yuan G … +8 more , Dai J, Yuan F, Song Y, Zhu D, Zhang T, Lei H, Li J, Liu N
BMC Urol · 2026 May · PMID 42186046 · Full text
BACKGROUND: Active surveillance (AS) is an established management strategy for low-risk prostate cancer (PCa). However, its real-world implementation in China remains limited. This study aimed to present the outcomes of...
BACKGROUND: Active surveillance (AS) is an established management strategy for low-risk prostate cancer (PCa). However, its real-world implementation in China remains limited. This study aimed to present the outcomes of patients with early-stage PCa undergoing AS and to identify the main obstacles encountered in the promotion of AS. METHODS: We conducted a two-part study consisting of a prospective observational cohort of patients who elected for AS at a tertiary cancer center (2012-2017) and a nationwide cross-sectional survey of urologists assessing their knowledge, attitudes, and practice patterns regarding AS. Clinical outcomes, adherence to follow-up, and treatment conversion were evaluated in the cohort. Survey responses were analyzed across hospital level and physician seniority. RESULTS: Among the 452 patients with localized PCa evaluated during the study period, 20 met the eligibility criteria and selected AS. After a median follow-up period of 118 months, 13 patients transitioned to definitive treatment, most commonly because of suspected disease progression. Three deaths occurred, one of which was a PCa-specific death. Adherence to scheduled PSA monitoring was high, whereas repeat biopsy compliance was low. The survey included 343 valid physician responses. Familiarity with AS eligibility and follow-up protocols was significantly higher among physicians in academic hospitals and those with senior titles. However, < 10% reported having structured AS follow-up programs, and most perceived patient anxiety and preference for surgery as major barriers to AS implementation. CONCLUSIONS: AS may be a feasible management option for carefully selected Chinese patients. Efforts to expand AS use in China should prioritize patient education, structured follow-up systems, national registry development, and supportive health policy measures.
HSF4 promotes renal cell carcinoma progression and is associated with PI3K/Akt pathway.
Li Y, Xie H, Dong C … +13 more , Yu T, Wu S, Cui X, Xiang C, Tao H, Liang N, Guo J, Yang Y, Yang J, Li X, Cha J, Wang W, Lin C
BMC Urol · 2026 May · PMID 42185995 · Full text
BACKGROUND: Renal cell carcinoma (RCC) is a common urological malignancy, accounting for approximately 2% of global cancer-related mortality. Heat shock factors (HSFs) are transcription factors that regulate cell stress...
BACKGROUND: Renal cell carcinoma (RCC) is a common urological malignancy, accounting for approximately 2% of global cancer-related mortality. Heat shock factors (HSFs) are transcription factors that regulate cell stress reaction. However, the exact mode of action of HSF4 in cancer, particularly RCC, is still unknown. OBJECTIVE: To investigate the expression pattern of HSF4 in RCC and its potential molecular mechanism (especially the association with the PI3K/Akt pathway), so as to identify a new therapeutic target for RCC. METHODS: Bioinformatics analyses were performed to assess HSF4 expression and its prognosis relevance in RCC. The effects of HSF4 on RCC were studied with both in vitro and in vivo experiments. The transcriptome sequencing results were analyzed for both the gene knockdown and control RCC cells to predict relevant RCC signaling pathways. RESULTS: Our experimental results indicate that HSF4 knockdown can prevent the occurrence and spread of RCC in the body, as well as the growth and invasion of RCC cells. Mechanistically, HSF4 knockdown led to a significant decrease in the protein levels of PI3K, p-AKT, β-catenin, and c-Myc. These findings demonstrate that HSF4 promotes RCC progression by concurrently activating the PI3K/AKT and Wnt/β-catenin signaling pathways. CONCLUSION: Our findings identify that HSF4 is highly expressed in RCC and can promote the occurrence and development of RCC. Therefore, HSF4 may be a potential therapeutic target for RCC.
Bladder-sparing chemoradiotherapy following neoadjuvant chemotherapy for muscle-invasive bladder cancer: a retrospective cohort study.
Mofid B, Jafari A, Simforoosh N … +6 more , Basiri A, Siavashpour M, Siavashpour Z, Zabihi MS, Ghajari M, Razzaghdoust A
BMC Urol · 2026 May · PMID 42185887 · Full text
PURPOSE: Radical cystectomy following cisplatin-based neoadjuvant chemotherapy (NAC) is still the standard approach for managing muscle-invasive bladder cancer (MIBC); however, a substantial proportion of patients are no...
PURPOSE: Radical cystectomy following cisplatin-based neoadjuvant chemotherapy (NAC) is still the standard approach for managing muscle-invasive bladder cancer (MIBC); however, a substantial proportion of patients are not candidates for surgery or cisplatin-based chemotherapy. The role of NAC followed by chemoradiation (CRT) in a bladder-preserving approach is not well established. This study aimed to evaluate the feasibility, survival outcomes, and prognostic factors associated with NAC followed by definitive CRT. MATERIALS AND METHODS: We retrospectively analyzed MIBC patients treated with NAC and subsequent CRT between 2010 and 2023. Overall survival (OS) and event-free survival (EFS) were analyzed using the Kaplan-Meier method and Cox proportional hazards models. RESULTS: Among 224 MIBC patients treated with NAC, 132 patients received bladder-preserving CRT after NAC. The median OS for the entire cohort was 58 months (95% CI: 37.63-78.37). Median OS was significantly longer in patients with clinical complete response (cCR) compared with those without (73 vs. 29 months, p = 0.007). Median EFS was also superior in the cCR group (50 vs. 23 months, p = 0.022). In multivariable Cox regression analysis, achievement of cCR was independently associated with superior OS (HR 0.52, 95% CI 0.30-0.92, p = 0.028) and EFS (HR 0.54, 95% CI 0.32-0.93, p = 0.036). Moreover, the presence of baseline hydronephrosis predicted significantly worse OS (HR 2.37, 95% CI 1.32-4.25, p = 0.006) but showed no association with EFS. The type of NAC regimen (cisplatin vs. carboplatin) had no independent effect on survival. CONCLUSION: NAC followed by CRT is a feasible bladder-preserving approach for selected patients with MIBC, including those ineligible for cystectomy or cisplatin. Achievement of cCR is the most robust prognostic factor for both OS and EFS, supporting its role as a surrogate endpoint in this setting. These findings provide novel evidence for integrating NAC into bladder-preserving strategies and highlight clinical factors that may guide individualized treatment selection. A prospective randomized trial is warranted.
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