Urology[JOURNAL]
Sun
200 papers
Ureteral wall thickness as an imaging-based predictor of difficult ureter during ureteroscopic lithotripsy: a retrospective analysis.
Chen Y, Zhang J, Li L … +3 more , Shen Y, Guo X, Li G
BMC Urol · 2026 May · PMID 42185823 · Full text
OBJECTIVE: To evaluate the value of ureteral wall thickness (UWT) obtained from non-contrast computed tomography (NCCT) for predicting difficult ureter (DU) among patients receiving ureteroscopic lithotripsy (URS). METHO...
OBJECTIVE: To evaluate the value of ureteral wall thickness (UWT) obtained from non-contrast computed tomography (NCCT) for predicting difficult ureter (DU) among patients receiving ureteroscopic lithotripsy (URS). METHODS: Patients with unilateral ureteral stones managed by URS were retrospectively reviewed. According to intraoperative findings, they were classified into DU or non-DU group. UWT was measured at the level of the stone on preoperative NCCT. Multivariate logistic regression was used to identify independent predictors. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of UWT for predicting DU. RESULTS: A total of 271 patients managed with URS were enrolled in the study, with 67 (24.72%) in the DU group and 204 (75.28%) in the non-DU group. The mean UWT in the DU group was 3.77 ± 1.24 mm, which was significantly higher than that in the non-DU group. Multivariate logistic regression revealed that UWT was an independent risk factor for DU, with an OR of 2.139 (95% CI: 1.634-2.79). The ROC curve demonstrated that a UWT cutoff of 2.9 mm provided the best threshold for predicting DU, with sensitivity and specificity levels of 77.6% and 71.6%, with an area under the ROC curve (AUC) of 0.786. Moreover, a UWT greater than 2.9 mm was associated with abnormal endoscopic findings during surgery, prolonged operative time, and a reduced stone-free rate. CONCLUSION: UWT is an independent risk factor for DU. Preoperative measurement of UWT holds significant value in predicting DU. These findings may assist in surgical planning before URS.
The causal association between seven drugs and erectile dysfunction: a Mendelian randomization study.
Zhan J, Liu J, Huang Y … +1 more , Jiang L
Ther Adv Urol · 2026 · PMID 42182083 · Full text
OBJECTIVE: Many studies have shown that patients develop erectile dysfunction (ED) after taking or aggravating certain drugs. However, other studies have considered such conclusions to be inaccurate. To explore the genet...
OBJECTIVE: Many studies have shown that patients develop erectile dysfunction (ED) after taking or aggravating certain drugs. However, other studies have considered such conclusions to be inaccurate. To explore the genetically predicted associations between drug treatment and ED, we used publicly available genome-wide association study (GWAS) data to evaluate the relationship between seven drug treatment regimens and ED using two-sample Mendelian randomization (MR) analysis. DESIGN: In this study, a two-sample Mendelian randomized design was used to evaluate the causal relationship between 40 drugs and the risk of ED using publicly available pooled data from the GWAS. METHODS: We employed five methods for MR analysis: MR-Egger, weighted median, inverse variance weighted (IVW), simple mode, weighted mode, MR-Egger intercept test, MR pleiotropy residual sum, and outlier global test to identify horizontal pleiotropy. Cochran's statistics were used for instrument heterogeneity tests, and the leave-one-out method was used for sensitivity analysis. RESULTS: The results showed that simvastatin ( = 0.023), ramipril ( = 0.041), metformin ( = 0.00061), gliclazide ( = 0.015), atorvastatin ( = 0.037), atenolol ( = 0.0052), aspirin ( = 0.051), and simvastatin, and five other drugs were potentially associated with ED. After excluding confounding single-nucleotide polymorphisms (SNPs), the -value of aspirin was slightly above 0.05, suggesting that aspirin may not have a potential causal relationship with ED, warranting further investigation to confirm this finding. No potential causal relationships were found between the remaining 33 exposures and ED. CONCLUSION: Genetically predicted associations suggest that there may be potential causal relationships between simvastatin, ramipril, metformin, gliclazide, atorvastatin, atenolol, and ED, which require further research.
Comparison of suction and standard ureteral access sheath versus sheathless flexible ureteroscopy in management of upper ureteral and renal calculi.
Zanaty F, Ali M, Elserafy F … +1 more , Abozaid M
BMC Urol · 2026 May · PMID 42178535 · Full text
PURPOSE: Comparative effectiveness of suction versus traditional ureteral access sheath (UAS) remains an area of ongoing research. We aim to compare the outcomes of retrograde intrarenal surgery (RIRS) with suction and s...
PURPOSE: Comparative effectiveness of suction versus traditional ureteral access sheath (UAS) remains an area of ongoing research. We aim to compare the outcomes of retrograde intrarenal surgery (RIRS) with suction and standard UAS versus without UAS in the management of renal and upper ureteric stones, with a specific focus on operative efficiency, stone-free rates, and postoperative complications. METHODS: This study was conducted between October 2023 and January 2025, including 90 patients with renal stones ≤ 3 cm and upper ureteric stones ≤ 1.5 cm. Patients were divided into three groups by random Allocation Software (version 2): Group A1 (standard UAS, n = 30), Group A2 (suction UAS, n = 30), and Group B (no UAS, n = 30). Operative time, vision quality, stone clearance, complications, and hospital stay were assessed. RESULTS: Group A2 had the shortest mean operative time (70.1 ± 10.3 min) with significantly better vision compared to Group A1 (114.3 ± 27.0 min) and Group B (125.0 ± 28.01 min) (p < 0.001). Residual stone rates were lowest in Group A2 (3.3%) compared to Group A1 (10.0%) and Group B (26.7%) (p = 0.035). The need for a second procedure was significantly higher in Group B (26.7%) compared to Group A1 (10.0%) and absent in Group A2 (p = 0.002). Hospital stay was significantly shorter in Group A2 compared to Group A1 and Group B (p = 0.005). Fever incidence (Clavien Grade II) was significantly higher in Group B (23.3%) compared to Group A1 (16.7%) and absent in Group A2 (p = 0.005). CONCLUSION: Suction ureteral access sheaths in flexible ureteroscopic lithotripsy for renal stones ≤ 3 cm and upper ureteric stones ≤ 1.5 cm was associated with improved stone clearance, reduced operative time and hospital stay, provide better endoscopic vision, minimized infectious complications and need for second procedure, compared to standard UAS or no sheath. However, outcomes may be influenced by surgeon experience and familiarity with suction-assisted systems. Prospective multicenter studies with larger sample sizes and varying surgeon experience levels are recommended.
Voiding dysfunction in pelvic organ prolapse mimicking obstruction: an unusual presentation of sacral chordoma - A case report.
Saraluck A, Harncharoenkul P, Wattanayingcharoenchai R
BMC Urol · 2026 May · PMID 42177451 · Full text
BACKGROUND: Pelvic organ prolapse (POP) is commonly associated with voiding dysfunction, often presumed to result from bladder outlet obstruction. However, neurological or structural lesions may mimic or coexist with pro...
BACKGROUND: Pelvic organ prolapse (POP) is commonly associated with voiding dysfunction, often presumed to result from bladder outlet obstruction. However, neurological or structural lesions may mimic or coexist with prolapse-related dysfunction. Sacral chordoma is a rare malignant tumor that can compress sacral nerves and present with lower urinary tract symptoms. CASE PRESENTATION: We describe a 71-year-old multiparous Thai woman with stage II POP and mild lower urinary tract symptoms, including occasional stress incontinence, rare urgency, and mild voiding difficulty, initially not affecting her quality of life. She also reported constipation, which improved with dietary changes. Pessary use was discontinued due to discomfort, and surgical management for POP was subsequently considered. Five months later, she developed progressive urinary retention requiring Foley catheterization. Urodynamics revealed normal bladder sensation and compliance but absent detrusor contractions, with residual volume of ~ 550 mL, consistent with acontractile detrusor. Initial pelvic MRI demonstrated a 10.0 × 6.7 × 9.4 cm sacral/presacral mass involving S1-S3 vertebrae and sacral foramina. Biopsy confirmed conventional chordoma. Planned colpocleisis was cancelled, and the patient was referred for multidisciplinary care. En bloc resection was not feasible; proton beam radiotherapy was initiated. Bladder management required chronic catheterization, while constipation was treated conservatively. At follow-up, POP remained but was less distressing compared with tumor-related symptoms. CONCLUSIONS: This case highlights an unusual neurourological presentation of sacral chordoma in a woman with POP. It emphasizes that not all voiding dysfunction in prolapse results from obstruction. Atypical findings, especially detrusor underactivity, should prompt further imaging to exclude neurological or structural causes. Comprehensive preoperative evaluation, including urodynamic studies, is essential in patients with pelvic organ prolapse and suspected detrusor underactivity to ensure accurate diagnosis and to avoid inappropriate surgical intervention, in line with current clinical guidelines. Early recognition prevents misdiagnosis and inappropriate surgery.
When double-J stents become a risk: bilateral distal ureteric urothelial carcinoma following ureteric instrumentation: a case report.
Eldesouki S, Elmekresh A, Esmaeilpour H … +4 more , Kumar S, Alsel KA, Azad EM, Bagheri F
BMC Urol · 2026 May · PMID 42174561 · Full text
BACKGROUND: Metachronous upper tract urothelial carcinoma (UTUC) is an uncommon but clinically significant event in patients with non-muscle-invasive bladder cancer (NMIBC), particularly in those with high-risk or recurr...
BACKGROUND: Metachronous upper tract urothelial carcinoma (UTUC) is an uncommon but clinically significant event in patients with non-muscle-invasive bladder cancer (NMIBC), particularly in those with high-risk or recurrent disease. Proposed mechanisms include field cancerization and intraluminal tumor seeding, while ureteric instrumentation has been discussed as a potential contributing factor. Emerging evidence suggests that retrograde ureteric stent placement performed concurrently with transurethral resection of bladder tumor (TURBT) may be associated with an increased risk of subsequent upper tract involvement. We report the first case of bilateral distal ureteric urothelial carcinoma developing in close temporal association with first-time ureteric stent placement in a patient with recurrent NMIBC. CASE REPORT: A 78-year-old man with recurrent high-grade NMIBC underwent bilateral ureteric stent placement during TURBT for obstructive uropathy, with no prior evidence of UTUC. Within months, imaging demonstrated progressive distal ureteric abnormalities. Subsequent cystoscopy and bilateral ureteroscopy revealed extensive papillary tumors involving both distal ureters with proximal extension, in addition to recurrent bladder lesions. Histopathology confirmed high-grade, non-muscle-invasive urothelial carcinoma. At re-intervention, both indwelling stents were encased within tumor tissue. CONCLUSION: This case highlights the multifactorial nature of metachronous UTUC in patients with recurrent bladder cancer and supports the hypothesis that ureteric instrumentation may contribute to upper tract tumor dissemination in selected high-risk settings. Careful consideration of urinary diversion strategies and close upper tract surveillance remain important when managing patients with active bladder urothelial carcinoma.
Prostatic acid phosphatase: a rediscovered target in prostate cancer.
Koehler D, Maurer T
Nat Rev Urol · 2026 May · PMID 42174222 · Publisher ↗
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Frailty and Quality of Life in Low-Income, Uninsured Men With Prostate Cancer.
Varghese E, Chen J, Kwan L … +1 more , Litwin MS
Urology · 2026 May · PMID 42173261 · Publisher ↗
OBJECTIVE: To evaluate frailty across multiple domains and examine its association with prostate cancer (PCa)-specific health-related quality of life (HRQoL) in low-income, uninsured men enrolled in the Improving Access,...
OBJECTIVE: To evaluate frailty across multiple domains and examine its association with prostate cancer (PCa)-specific health-related quality of life (HRQoL) in low-income, uninsured men enrolled in the Improving Access, Counseling and Treatment for Californians with Prostate Cancer (IMPACT) Program. MATERIALS AND METHODS: We retrospectively assessed frailty using a deficit accumulation frailty index, derived from the RAND SF-12v2 (12-Item Short Form Survey, version 2), California Health Interview Survey (CHIS), and Total Illness Burden Index for Prostate Cancer (TIBI-CaP). PCa-specific HRQoL was measured at IMPACT enrollment, using the UCLA Prostate Cancer Index (PCI), which covers urinary, sexual, and bowel function and bother. We analyzed associations between frailty status and PCI domains using multivariable logistic regression. RESULTS: Among 342 participants (mean age: 60; 68% Hispanic), 25% were frail, 46% were pre-frail, and 29% were non-frail. Across all PCI domains, PCa-specific HRQoL was significantly worse in the pre-frail and frail groups. Sexual function demonstrated the greatest impairment (mean ± SD: non-frail 54.1 ± 33.9 vs pre-frail 38.2 ± 31.3 vs frail group 24.6 ± 28.9, P < .0001). After covariate adjustment, both pre-frailty and frailty remained independently associated with worse PCa-specific HRQoL. CONCLUSION: Frailty is significantly associated with poorer PCa-specific HRQoL in low-income, uninsured men. These findings suggest that comprehensive frailty assessment has a role in guiding personalized interventions to improve genitourinary HRQoL outcomes in men with PCa.
Urine Proteins Stratify Patient Symptom Severity Phenotypes in Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study.
Froehlich JW, Lee T, Logvinenko T … +5 more , Das B, van Bokhoven A, Moses MA, Lee RS, MAPP Research Network
Urology · 2026 May · PMID 42173260 · Full text
OBJECTIVE: To define a set of urinary proteins that correlate with symptom severity in urologic chronic pelvic pain syndrome (UCPPS) and validate a putative molecular test for symptom severity based on quantitatively var...
OBJECTIVE: To define a set of urinary proteins that correlate with symptom severity in urologic chronic pelvic pain syndrome (UCPPS) and validate a putative molecular test for symptom severity based on quantitatively varying urinary proteins. MATERIALS AND METHODS: Quantitative urinary proteomic analysis of 81 UCPPS subjects was performed. Patients were stratified into "severe" (n = 37) and "non-severe" (n = 44) subpopulations based on summing pain and urinary severity scores which were derived from the GenitoUrinary Pain Index (GUPI) questionnaire. RESULTS: Utilizing quantitative urinary proteomics, a total of 118 proteins were significantly altered (P < .05) between the severe and non-severe UCPPS severity subpopulations. We developed a logistic regression model using 4-fold cross-validation to identify a panel of 5 proteins with a ROC AUC of 0.928 to distinguish severe and non-severe UCPPS subpopulations. A parallel analysis of the proteomics data using a decision tree analysis performed similarly. Further validation is needed in future studies. CONCLUSION: UCPPS patients with severe pain and urinary symptoms have quantitatively distinct urinary proteins compared to UCPPS patients with less severe symptoms. These protein markers require validation but could potentially be used as an objective symptom severity metric. A subset of these differentially regulated proteins can differentiate severe and non-severe UCPPS patients with high sensitivity and specificity. Informatic analysis of the quantitatively altered urinary proteome implicates putative therapeutic targets.
Real-World Patterns of Genetic Testing in Urologic Malignancies: Guideline Recommendations Versus Clinical Practice.
Manivasagam SS, Raman JD
Urology · 2026 May · PMID 42173259 · Publisher ↗
OBJECTIVE: To analyze current utilization patterns and identify potential disparities regarding genetic testing rates among eligible patients with urologic cancers using a large national database. METHODS: We conducted a...
OBJECTIVE: To analyze current utilization patterns and identify potential disparities regarding genetic testing rates among eligible patients with urologic cancers using a large national database. METHODS: We conducted a retrospective analysis of patients diagnosed with urologic cancers between 2021 and 2024 using TriNetX. Eligibility for genetic testing was determined based on AUA and NCCN guidelines for each cancer in 2021. We assessed the proportion of eligible patients who underwent genetic testing within 1 year of diagnosis, based on ICD-10 and CPT codes. RESULTS: Among 125,860 eligible patients, 12,713 (10.1%) underwent counseling/testing within 1 year. Disease-specific rates were as follows: kidney 9.1% (n = 8317), adrenal 8.9% (n = 11,325), upper tract urothelial carcinoma (UTUC) 16.2% (n = 3209), bladder 8.6% (n = 8131), and prostate 10.2% (n = 94,878). Patients who completed genetic testing were significantly younger across all cancer types (P < .05). By race, among eligible patients, those who completed testing were more often White compared with those who did not complete testing-kidney (68.4% vs 63.0%, P = .005), adrenal (70.0% vs 66.0%, P = .01), bladder (77.0% vs 71.0%, P = .002), and prostate (79.0% vs 72.0%, P < .001). In prostate cancer specifically, Black men were under-represented among those tested compared with those not tested (14% vs 21%, P < .001). CONCLUSION: Despite clear guideline recommendations, genetic testing remains underutilized across urologic cancers, with significant disparities by disease type, age, and race. These results emphasize the importance of ongoing provider education, system-level support, and equity-focused strategies to enhance uptake of genetic testing in urologic oncology practice.
Is BMP-7 a promising diagnostic and prognostic biomarker for pediatric obstructive uropathy?
Shirazi M, Hosseini SH, Salehi M … +1 more , Shirazi S
BMC Urol · 2026 May · PMID 42163193 · Full text
BACKGROUND: Obstructive uropathy remains a major contributor to pediatric chronic kidney disease. Reliable biomarkers that predict disease progression or recovery are still lacking. Bone morphogenetic protein-7 (BMP-7),...
BACKGROUND: Obstructive uropathy remains a major contributor to pediatric chronic kidney disease. Reliable biomarkers that predict disease progression or recovery are still lacking. Bone morphogenetic protein-7 (BMP-7), known for its anti-fibrotic and renoprotective properties, has been proposed as a promising biomarker in renal injury. This study aimed to assess serum and urinary BMP-7 levels in pediatric obstructive uropathy and to evaluate its potential diagnostic and prognostic significance. METHODS: This prospective observational study enrolled 200 pediatric patients with obstructive uropathy (including UPJO, UVJO, and PUV) and 200 healthy controls. Serum and urinary BMP-7 levels were measured before and three months after surgery using a human BMP-7 ELISA kit (Zellbio). Comparisons were made between groups and between pre- and postoperative measurements using appropriate statistical analyses. RESULTS: Urinary BMP-7 levels were marginally higher and serum BMP-7 levels slightly lower in patients than in controls; however, these differences were not statistically significant (P > 0.05). Postoperative evaluations revealed a minor decrease in urinary BMP-7 and a mild increase in serum BMP-7, but again without statistical significance. No significant variations were found among obstruction subtypes (UPJO, UVJO, PUV). CONCLUSION: While BMP-7 plays a recognized role in renal repair in experimental models, its clinical diagnostic and prognostic utility in pediatric obstructive uropathy appears limited. Future research incorporating additional biomarkers and longer follow-up may further elucidate BMP-7's potential in predicting renal recovery and fibrosis modulation.
Editorial Comment on "The Current Role of Artificial Intelligence in Urology Training: A Review of Available Platforms and Their Potential Applications".
Baas W
Urology · 2026 May · PMID 42162628 · Publisher ↗
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Reply to Editorial Comment on "High Abdominal Aortic Calcium Scores are Associated with Renal Function Decline Following Radical Nephrectomy".
Jlilati A, Thiel DD, Farres H
Urology · 2026 May · PMID 42162627 · Publisher ↗
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Editorial Comment on "Urologic Traumas at a Level I Trauma Center in West Virginia: Exploring Injury Patterns".
Appleton A, Patel HV
Urology · 2026 May · PMID 42162626 · Publisher ↗
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Aquablation for dual burden disease - BPH and chronic prostatitis/chronic pelvic pain syndrome: a single-center prospective pilot study.
Ghanim AF, Moschovas MC, Injiac J … +4 more , Chiriboga A, Allegro S, Rivera T, McDonald M
BMC Urol · 2026 May · PMID 42157180 · Full text
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) accounts for approximately 90-95% of prostatitis cases and is defined by pelvic pain or discomfort persisting for at least three of the preceding six...
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) accounts for approximately 90-95% of prostatitis cases and is defined by pelvic pain or discomfort persisting for at least three of the preceding six months in the absence of identifiable infection. Despite its high prevalence, management remains challenging, and no standardized treatment approach has been established. In men with concomitant benign prostatic hyperplasia (BPH), bladder outlet obstruction may contribute to symptom persistence or severity. Aquablation, a robot-assisted, waterjet-based therapy used for the treatment of BPH, enables precise, heat-free prostatic tissue removal and may provide symptomatic benefit in this clinical setting. METHODS: We performed a prospective pilot study including 20 men aged 45 years or older with diagnoses of both BPH and CP/CPPS who reported clinically significant symptoms, defined as an NIH-CPSI score of 8 or greater at screening. All patients underwent Aquablation between July and December 2024 and were evaluated at 1, 3, and 6 months following the procedure. Primary outcome measures included changes in International Prostate Symptom Score (IPSS) and NIH-CPSI, with assessment across pain, urinary, and quality-of-life (QoL) domains. RESULTS: Significant improvements in both IPSS and NIH-CPSI scores were observed by 3 months postoperatively (p < .001), with further modest and sustained improvements noted at 6 months. The greatest symptom reductions were seen in pain and quality-of-life domains. No major adverse events occurred during the study period. CONCLUSIONS: Aquablation was associated with improvement in both lower urinary tract symptoms and CP/CPPS-related symptom measures in men with coexisting BPH and CP/CPPS. These preliminary findings support further investigation of Aquablation as a potential treatment option for selected patients with this challenging clinical overlap.
The Relationship Between Burnout, Perfectionism, and Grit in Urology.
Schammel J, Inouye BM, Feustel PJ … +2 more , Hines L, Kogan BA
Urology · 2026 May · PMID 42155810 · Publisher ↗
OBJECTIVE: To evaluate associations between burnout, perfectionism, and grit among urology residents and attendings, hypothesizing that perfectionism would be associated with increased burnout and higher grit would be pr...
OBJECTIVE: To evaluate associations between burnout, perfectionism, and grit among urology residents and attendings, hypothesizing that perfectionism would be associated with increased burnout and higher grit would be protective. METHODS: We conducted a prospective, multi-institutional cross-sectional survey from January to May 2025. Participants completed the Maslach Burnout Inventory, Frost Multidimensional Perfectionism Scale, and Grit Scale. Burnout was defined as Emotional Exhaustion >27 or Depersonalization >10. Perfectionism and grit scores (2-5) were analyzed relative to burnout, including analyses of individuals above the 90th percentile for perfectionism. RESULTS: A total of 108 urologists responded (39% response rate), including 68 attendings (64%) and 39 residents (36%); 70% completed the perfectionism scale. Burnout was identified in 56 respondents (52%; 95% CI, 42%-62%) and was more common among residents than attendings (77% vs 37%; P <.001). Perfectionism showed non-linear association with burnout: moderate levels were associated with lower burnout, while scores above the 90th percentile were associated with higher burnout (77% vs 46%; OR 3.9; 95% CI, 1.3-11.2; P <.01). Grit was inversely associated with burnout; 92% of respondents with low grit were burned out versus 7% with the highest grit (P <.001). CONCLUSION: Burnout remains prevalent among urologists, particularly trainees. Perfectionism is associated with higher burnout, while grit appears strongly protective, suggesting potential targets for intervention.
Spectrum of sexual health: exploring all dimensions across ages and genders.
Pearlman AM
Ther Adv Urol · 2026 · PMID 42152831 · Full text
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Culture-detected urinary bacteria 10-20 years after tension-free vaginal tape surgery and associations with incontinence, pelvic pain, and dissatisfaction: a cross-sectional study.
Volløyhaug I, Solhaug BR, Larssen KW … +4 more , Haugum K, Nyhus MØ, Svenningsen R, Afset JE
BMC Urol · 2026 May · PMID 42151963 · Full text
BACKGROUND: Some women have persistent incontinence or pain after tension-free vaginal tape (TVT) surgery. Our objective was to study any association between culture-detected bacteriuria and incontinence, complications a...
BACKGROUND: Some women have persistent incontinence or pain after tension-free vaginal tape (TVT) surgery. Our objective was to study any association between culture-detected bacteriuria and incontinence, complications and satisfaction 10-20 years after TVT. METHODS: Cross-sectional study in 2022 of 127 women operated with TVT between 2001-2012 at Trondheim University Hospital, Norway. Validated questionnaires assessed stress urinary incontinence (SUI), urgency urinary incontinence (UUI), pelvic pain and satisfaction. Urine collected by sterile catheterization was cultivated for two (chromogenic and blood agar) and five days (blood, fastidious and chocolate agar). Symptoms and demographics were compared between women with and without significant bacterial growth, defined as ≥ 1.000 CFU/ml for this study, using chi-square test, Fishers exact test, t-test and logistic regression. Number of species detected after five days culture was tested in association to demographics and symptoms using Mann Whitney-U-test. RESULTS: 50/111 women (45.0%) had SUI, 54/122 (44.3%) had UUI, 95/116 (81.9%) were satisfied and 7/123 (5.7%) stated persistent pain. 16 (12.4%) had significant bacterial growth after two days of whom seven (44%) had a positive dipstick screening test (leukocytes or nitrite). After five days culture, 28 (22%) had significant bacterial growth. We found non-significantly higher odds for SUI (aOR 4.2, 95% CI 0.5-36.1) and UUI (aOR 2.1, 95% CI 0.3-13.7) in women with bacterial growth after two days. Bacterial growth after five days was associated with non-significantly increased risk of SUI (aOR 2.3, 95% CI 0.6-8.9) and UUI (aOR 3.4, 95% CI 0.9-13.6). Age was significantly associated with bacterial growth after two (aOR 1.2, 95% CI 1.02-1.3) and five days (aOR 1.1, 95% CI 1.04-1.2). The number of bacterial species after five days culture was higher in women with UUI, BMI > 75 percentile, in those dissatisfied or with persistent pain, than in women without these conditions (p < 0.01). CONCLUSIONS: Significant bacteriuria and larger variety of bacterial species were associated with incontinence, pain and dissatisfaction 10-20 years after TVT. The dipstick screening test had a sensitivity of only 44%. Extended urinary culture may be of value in optimizing treatment of urinary tract symptoms after TVT. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04912830).
Robot-assisted nephrectomy for retroperitoneal liposarcoma compressing the kidney: a case report with urological management perspective.
Shen H, Wang Y, Dong Z … +1 more , Wu J
BMC Urol · 2026 May · PMID 42151908 · Full text
BACKGROUND: Liposarcoma (LS) is the second most common histological subtype of soft tissue sarcoma, accounting for approximately 7% of all soft tissue sarcomas, among which retroperitoneal liposarcoma (RPLS) is not a rar...
BACKGROUND: Liposarcoma (LS) is the second most common histological subtype of soft tissue sarcoma, accounting for approximately 7% of all soft tissue sarcomas, among which retroperitoneal liposarcoma (RPLS) is not a rare clinical entity. While RPLS involving the kidney and requiring combined urological management is relatively uncommon with limited clinical reports, it is often asymptomatic in the early stage, with clinical symptoms appearing only when the tumor compresses adjacent organs. Surgical resection is the cornerstone of treatment. CASE PRESENTATION: A 54-year-old female was diagnosed with a well-differentiated giant retroperitoneal RPLS (250 mm × 92 mm) compressing the right kidney via contrast-enhanced MRI. After strict multidisciplinary evaluation in accordance with the 2024 NCCN Guidelines for Soft Tissue Sarcoma, preoperative core needle biopsy was not performed, and the retroperitoneal approach was selected for surgical intervention. On August 6, 2024, Da Vinci Xi Surgical System robot-assisted retroperitoneal tumor resection combined with right nephrectomy and retroperitoneal lymph node dissection was successfully completed via the retroperitoneal approach. Postoperative pathology and immunohistochemistry (MDM2 (+), S-100 (+), etc.) confirmed the diagnosis. The patient recovered uneventfully and was discharged on postoperative day 6 with individualized adjuvant targeted therapy. Follow-up CT scans at 3 months, 6 months, and 1 year postoperatively showed no tumor recurrence, and laboratory examinations such as serum creatinine were normal. This case preliminarily confirms the feasibility and safety of robot-assisted retroperitoneal approach for strictly selected giant RPLS (> 20 cm) confined to the retroperitoneal space, and provides a standardized urological management reference for similar cases. DISCUSSION: Most existing robot-assisted retroperitoneal liposarcoma (RPLS) surgeries are performed via the transabdominal approach, and the reported cases of retroperitoneal approach are limited to moderately sized tumors (diameter < 10 cm). This case demonstrates the feasibility and safety of robot-assisted retroperitoneal approach for giant RPLS (> 20 cm) strictly confined to the retroperitoneal space, expands the application scope of this approach, and provides a standardized urological management strategy for RPLS compressing the kidney for clinical reference.
A dynamic nomogram and risk classification for predicting prognosis in renal cell carcinoma with venous tumor thrombus.
Zhou Z, Ge L, Zhang F … +5 more , Deng S, Zhang H, Wang G, Lu M, Zhang S
BMC Urol · 2026 May · PMID 42151905 · Full text
BACKGROUND: To establish an effective dynamic nomogram and a novel risk classification system to predict overall survival (OS) for Renal Cell Carcinoma with venous tumor thrombus (RCC-VTT). METHODS: 318 patients were enr...
BACKGROUND: To establish an effective dynamic nomogram and a novel risk classification system to predict overall survival (OS) for Renal Cell Carcinoma with venous tumor thrombus (RCC-VTT). METHODS: 318 patients were enrolled and randomly divided into a training set and a validation set in a 7:3 ratio. LASSO regression analysis and multivariate Cox regression analysis were employed to identify significant prognostic factors. Based on these factors, a nomogram model was developed and evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analyses (DCA). Survival differences were assessed using Kaplan-Meier curves and the log-rank test. RESULTS: Eight survival predictors were identified: Mayo Clinic Stage, Histology, N Stage, M Stage, Renal Sinus Invasion, Sarcomatoid Feature, Hemoglobin, and Estimated Glomerular Filtration Rate. The C-indexes for the training and validation sets were 0.77 (95% CI: 0.72-0.82) and 0.75 (95% CI: 0.68-0.82), respectively. The AUCs for the training and validation sets were 0.869 (95% CI: 0.805-0.933) and 0.854 (95% CI: 0.770-0.937) for the 5-yr predictions, respectively. DCA further confirmed the clinical utility of the model. Additionally, the nomogram-based classification system stratified patients into distinct risk subgroups for OS (P < 0.0001). CONCLUSIONS: We developed a dynamic nomogram and novel risk classification system for RCC-VTT. This tool has the potential to personalize treatment strategies.
Efficacy of ventral onlay autologous tunica vaginalis graft in bulbar urethroplasty: an 11-year experience.
Yalçın K, Kölükçü E
BMC Urol · 2026 May · PMID 42143265 · Full text
BACKGROUND: Urethral stricture disease in men has historically been one of the most challenging urological problems. The treatment of complex urethral strictures, in particular, poses a major challenge due to urethral sc...
BACKGROUND: Urethral stricture disease in men has historically been one of the most challenging urological problems. The treatment of complex urethral strictures, in particular, poses a major challenge due to urethral scarring and fibrosis of the surrounding corpus spongiosum. Although various tissue types have been proposed for surgical reconstruction, the optimal graft material remains a subject of ongoing debate. In this study, we aimed to analyze the efficacy of using a ventral onlay autologous tunica vaginalis graft (TVOG) in bulbar urethroplasty. METHODS: Data from 43 patients diagnosed with bulbar urethral stricture and treated with the ventral onlay TVOG technique at our clinic between 2011 and 2022 were retrospectively reviewed. Patient age, American Society of Anesthesiologists (ASA) score, stricture length, number of internal urethrotomies performed, operative time, etiological factors, body mass index (BMI), length of hospital stay, time-dependent uroflowmetry Qmax values, and postoperative complications were recorded. Criteria for success were defined as patient satisfaction, a Qmax value exceeding 16 mL/s, patent urethrogram findings, and the absence of any need for dilation or further instrumentation during the follow-up period. RESULTS: The overall success rate was 74,4%. Failure occurred in 6 cases due to severe wound infection. Recurrent urethral stricture was detected in 5 cases. Superficial surgical site infection or hematoma was observed in 6 cases. No diverticulum formation was observed in any patient. Successful voiding was achieved in a total of 33 cases, with uroflowmetry Qmax values measured at 17 mL/s or higher. Comparison of Qmax values demonstrated a statistically significant difference (p < 0.05). Furthermore, no patient reported scrotal pain or discomfort during the follow-up period. CONCLUSIONS: The outcomes of using ventral onlay TVOG in bulbar urethroplasty appear favorable. Based on the data obtained from our study, it can be concluded that TVOG may be considered an alternative method in this field.
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