Urology[JOURNAL]
Sun
200 papers
Pathologic Differences in Adult Acquired Buried Penis Patients by Exhumable Status.
Quinn A, Holum P, Daly W … +2 more , Klein R, Rusilko P
Urology · 2026 May · PMID 42142760 · Publisher ↗
OBJECTIVE: To compare the incidence of penile cancer and urethral stricture disease in patients undergoing surgical correction of adult-acquired buried penis disease whose penis cannot be adequately exposed for examinati...
OBJECTIVE: To compare the incidence of penile cancer and urethral stricture disease in patients undergoing surgical correction of adult-acquired buried penis disease whose penis cannot be adequately exposed for examination preoperatively with those whose penis can be fully exposed and examined. MATERIALS AND METHODS: We performed a single-arm retrospective cohort review of 203 patients who underwent adult acquired buried penis repair at single institution between 2013 and 2025. The ability to exhume patients' penises preoperatively was determined using electronic medical record photo review, operative reports, and outpatient documentation. The presence of lichen sclerosis or penile cancer was determined by a genitourinary pathologist. Statistical analysis was performed using two-tailed two sample T-test and Odds Ratio. RESULTS: The penile skin of patients whose penises could not be exposed preoperatively were significantly more likely to harbor lichen sclerosus than those whose penis could be exposed (28.4% vs 13.8%, OR 2.89, 95% CI 1.38, 6.08). There was no significant difference between penile cancer risk (6.5% vs 2.5%, OR 2.71, 95% CI 0.56, 13.12) or stricture risk (26.3% vs 35.0%, OR 1.51, 95% CI 0.81, 2.81). CONCLUSION: Patients with genitals who cannot be exposed for full preoperative examination are at higher risk for premalignant conditions. Clinicians should explicitly note the diagnostic uncertainly and increased risk of adverse pathology in patients whose genitals cannot be exposed as part of the shared decision-making process. Given the risks of observation in the setting of limited examination, upfront surgery should be strongly considered in this population.
Retrospective evaluation of clinical performance of three measurement catheter fixation methods in urodynamic studies.
Zeng X, Huang Z, Shen H … +2 more , Luo DY, Jin T
BMC Urol · 2026 May · PMID 42141422 · Full text
BACKGROUND: Catheter displacement during urodynamic studies remains a common challenge, potentially introducing artifacts, compromising test accuracy, and decreasing patient comfort. Despite the clinical significance of...
BACKGROUND: Catheter displacement during urodynamic studies remains a common challenge, potentially introducing artifacts, compromising test accuracy, and decreasing patient comfort. Despite the clinical significance of stable catheter fixation, evidence-based recommendations for optimal fixation techniques are lacking. This study seeks to address this gap by comparing the effectiveness and patient comfort associated with three commonly used catheter fixation methods during urodynamic study. METHODS: We retrospectively collected data from non-randomized patients who underwent urodynamic studies (UDS) at West China Hospital of Sichuan University between April and June 2023. Patients were selected based on predefined inclusion and exclusion criteria and assigned to one of three catheter fixation methods. The effectiveness of the following fixation techniques was evaluated: waterproof tape fixation (Group 1: catheter secured to the skin with adhesive tape), (2) patient-manual fixation (Group 2: patient holds the catheter manually throughout the procedure), and (3) silk thread fixation (Group 3: catheter secured with silk suture tied and fixed externally). RESULTS: A total of 168 patients were enrolled in the study, with 56 patients in each group. The median ages for Groups 1, 2, and 3 were 66 (47.25, 76), 67 (61,71), and 66 (48, 76.75) years, respectively. There were no statistically significant differences among the three groups in terms of maximum cystometric capacity (MCC), bladder compliance (BC), maximum flow rate (Qmax), detrusor pressure at Qmax (Pdet.Qmax), bladder contractility index (BCI), or bladder outlet obstruction index (BOOI) (P > 0.05). The overall incidence of catheter displacement was 35.71% in Group 1, 0% in Group 2, and 14.29% in Group 3. Statistically significant differences in Comfort-B scale scores were observed between Group 1 and Group 2, and between Group 2 and Group 3 (P < 0.000). Similarly, visual analogue scale (VAS) scores also showed significant differences between Group 1 and Group 2, and between Group 2 and Group 3 (P < 0.000). CONCLUSIONS: Our preliminary assessment indicated that the three catheter fixation methods did not significantly influence urodynamic parameters. Notably, patient-manual fixation achieved the lowest catheter displacement rate (0%) but was associated with the highest pain and discomfort scores. In contrast, waterproof tape and silk thread fixation offered better patient comfort but with higher displacement rates. These findings highlight a trade-off between catheter stability and patient comfort, suggesting that fixation method selection should be individualized based on patient characteristics and procedural requireme. CLINICAL TRIAL NUMBER: Not applicable.
Unraveling the vaginal microbiota-based etiology of recurrent cystitis: the potential role of vaginal suppositories.
Sekito T, Hirakawa H, Sadahira T
Ther Adv Urol · 2026 · PMID 42137495 · Full text
Recurrent cystitis is a common problem in women that substantially impairs quality of life and contributes to increasing healthcare costs. Traditionally regarded as an ascending infection originating from the gut, recurr...
Recurrent cystitis is a common problem in women that substantially impairs quality of life and contributes to increasing healthcare costs. Traditionally regarded as an ascending infection originating from the gut, recurrent cystitis is now increasingly understood as a disorder rooted in vaginal dysbiosis, with the vagina acting as a key reservoir for uropathogenic . Loss of a -dominant vaginal microbiota and overgrowth of enteric and anaerobic bacteria are strongly associated with recurrent cystitis, particularly in postmenopausal women. species promote vaginal health by producing lactic acid, maintaining a low pH, generating antimicrobial compounds, inhibiting pathogen adhesion, and modulating mucosal immune responses. At the same time, long-term antimicrobial prophylaxis, although effective in reducing recurrences, is limited by adverse effects and the promotion of antimicrobial resistance. These concerns have driven interest in strategies that restore the protective vaginal ecosystem rather than relying on repeated antimicrobial exposure. This narrative review summarizes current concepts linking vaginal dysbiosis to recurrent cystitis, highlights the protective role of , and synthesizes clinical data on vaginal suppositories, particularly ()-based preparations, as a targeted, non-antimicrobial prophylactic option. Across pilot, phase II, and randomized trials, vaginal therapy has demonstrated a generally favorable safety and tolerability profile, with preliminary evidence suggesting a potential to reduce recurrent cystitis episodes while restoring a -dominant vaginal microbiota. However, larger, standardized studies are still needed. Collectively, these findings provide a rationale for investigating vaginal suppositories as a microbiome-informed, non-antimicrobial strategy for the long-term prevention of recurrent cystitis, particularly in postmenopausal and other high-risk women, and highlight the importance of further research to define the role of vaginal microbiota-directed therapies in future recurrent cystitis management.
Endoscopic management of vesicourethral anastomotic stenosis after radical prostatectomy: final outcomes defined by urethral patency and continence.
Andrzej SM, Łukasz B, Marta R … +2 more , Piotr G, Jakub D
Ther Adv Urol · 2026 · PMID 42137494 · Full text
BACKGROUND: Vesicourethral anastomotic stenosis (VUAS) remains a challenging sequela of radical prostatectomy (RP). OBJECTIVES: To evaluate endoscopic outcomes in men with VUAS using a patient-centred composite endpoint...
BACKGROUND: Vesicourethral anastomotic stenosis (VUAS) remains a challenging sequela of radical prostatectomy (RP). OBJECTIVES: To evaluate endoscopic outcomes in men with VUAS using a patient-centred composite endpoint of concurrent urethral patency and continence. DESIGN: Retrospective, single-centre consecutive case series. METHODS: We analysed 60 consecutive men treated endoscopically for VUAS (2014-2023). Primary endpoints were urethral patency (passage of a 20F catheter at 6-month follow-up) and continence (0-1 pad/day at last follow-up; for men with an artificial urinary sphincter (AUS), assessed after device activation). Secondary endpoints included AUS implantation and complications. Subgroup comparisons by prior pelvic radiotherapy (RTx) were performed using Fisher's exact and Mann-Whitney tests. RESULTS: Median follow-up was 40 months. Patency was achieved in 45/60 (75%). Continence was achieved in 22/60 (36.7%): 5 men remained continent without AUS and 17 became continent after AUS; 4/21 AUS required explant for erosion. Composite success (patency plus continence) occurred in 20/60 (33.3%). Prior RTx was not significantly associated with patency, continence, composite success, or AUS implantation. Three men required urinary diversion for pubic bone fistulation and three were diagnosed with bladder cancer (no AUS implanted). Seventeen patients declined AUS despite persistent stress urinary incontinence. CONCLUSION: Endoscopic treatment restores urethral patency in most men with post-RP VUAS, but the final patient-centred outcome of simultaneous patency and continence is achieved in one-third. These data may support shared decision-making regarding expectations and staged continence surgery. TRIAL REGISTRATION: Not applicable.
Transitional urology: a comprehensive review of the transitional care process.
Lopez AD, Kalaga I, Copp HL … +2 more , Shaw NM, Hampson LA
Nat Rev Urol · 2026 May · PMID 42135528 · Publisher ↗
When patients with congenital genitourinary conditions transition to adult care, they encounter multiple challenges, including management of multiple complex medical needs, understanding and navigating the healthcare sys...
When patients with congenital genitourinary conditions transition to adult care, they encounter multiple challenges, including management of multiple complex medical needs, understanding and navigating the healthcare system, and reconciling their condition with their social and psychological development. These issues translate directly into inferior short-term and long-term health outcomes, including increased emergency room visits after 18 years of age, persistent bothersome urinary symptoms, reduced quality of life and lack of appropriate urological management into adulthood. Conversely, smooth care transition enables improved age-appropriate subspecialty care and eases the burden of care on paediatric care providers. Transitional urology aims to aid adolescents and young adults, particularly those with complex healthcare needs, in successfully transitioning from paediatric to adult care. Transitional urology is one of the top ten highest-priority research topics in urology, but the existing body of research regarding transitional care remains relatively small. Knowledge and understanding of this patient population, including models of care, quantitative assessment of transition, stakeholder perspectives, common clinical challenges and barriers to establishing and maintaining transitional care programmes, can inform transitional care. Avenues of future transitional urology research include outcomes-based studies for specific pathologies, comparisons of different care implementation models, creation and evaluation of training opportunities and validation of resources created for non-urologic care team members. An idealized transition schema is proposed as both an example and guide to ground recommendations and data.
Identification of Novel Cytogenetic Alterations and Y Chromosome Microdeletions in Infertile Males.
Narayanan D, Patel TA, Chakraborty J
Urology · 2026 May · PMID 42134607 · Publisher ↗
OBJECTIVE: To conduct chromosome and Yq microdeletion analyses in infertile Indian Gujarati men. METHODS: We processed blood samples from 91 infertile and 10 fertile males to identify chromosomal abnormalities and microd...
OBJECTIVE: To conduct chromosome and Yq microdeletion analyses in infertile Indian Gujarati men. METHODS: We processed blood samples from 91 infertile and 10 fertile males to identify chromosomal abnormalities and microdeletions in European Academy of Andrology (EAA) markers of the azoospermia factor (AZF) region in Y chromosome via manual karyotyping and YqPCR. RESULTS: We report 4 cases of cytogenetic abnormalities and 4 cases with Yq microdeletion. We report first case of oligoasthenoteratozoospermia (OAT) with balanced t(3;12)(p21;q24) and first case of non-obstructive azoospermia with inv(6)(p21.1p11.2). Additionally, we report 2 patients diagnosed with oligoasthenozoospermia and OAT, have heteromorphism in the Y chromosome. Two azoospermic and 1 cryptozoospermic patient had the sY127 marker of AZFb region deleted. We also found deletion of the sY84 marker in AZFa region in an oligoasthenozoospermic patient. DISCUSSION: Male factors are implicated in half of infertile cases, where cost-effective genetic testing revolves around karyotyping and Yq microdeletion polymerase chain reaction (YqPCR). Genetic abnormalities are primarily reported for chromosomes 1 and 9; however, novel abnormalities continue to be reported. There are 24 genes associated with male infertility per Male Infertility Knowledgebase (MIK) in 3p21 and 12q24.1. Of these, the DNAH1 gene has strong association with male infertility in humans. Per the MIK, 9 genes located at 6p21.1 have functional role in male fertility. sY127 marker microdeletion is associated with oligozoospermic and azoospermic males. sY84 marker microdeletion is associated with normospermic, oligozoospermic, asthenozoospermic, and azoospermic males. Our study reiterates importance of karyotyping and YqPCR in the diagnosis of male infertility.
The Qualitative Experience of Early-Career Urologists: Challenges, Fulfillment, Support, and Advice.
Chau D, DiFiore G, Leng L … +4 more , Hacker E, Amare SZ, Van Kuiken M, Hampson LA
Urology · 2026 May · PMID 42134606 · Publisher ↗
OBJECTIVE: To characterize the barriers, support, and attitudes experienced by early-career urologists. METHODS: An online survey was sent to urologists within their first 10 years of graduating from residency. The surve...
OBJECTIVE: To characterize the barriers, support, and attitudes experienced by early-career urologists. METHODS: An online survey was sent to urologists within their first 10 years of graduating from residency. The survey was advertised at the American Urological Association (AUA) Conference, on X, and via email solicitation. A total of 263 responses were eligible for inclusion. Six open-ended questions were asked, focusing on topics of early-career challenges, fulfillment, and advice for new urologists. Two researchers independently performed inductive coding and reviewed discrepancies until consensus was achieved. A third researcher served as an adjudicator to review and make final thematic determinations. RESULTS: Thematic analysis revealed many takeaways regarding young urologists' initial years in clinical practice. Challenges primarily involved feelings of unpreparedness during the transition between residency and practice, including in billing knowledge and increased responsibility. Strong relationships in participants' personal and professional spheres were essential throughout this process. Future urologists were advised to center these meaningful relationships and work-life balance when starting or choosing a practice. Values of being an urologist, the nature of surgery, and positive patient relationships brought fulfillment to urologists. Hypothetical reasons to leave urology revolved around frustrations with the medical system and preserving personal well-being. CONCLUSION: Early-career urologists note a myriad of challenges and priorities when considering their new attending lives. There should be increased emphasis on the real-world skills needed to succeed as attendings, particularly as they pertain to managing one's practice and navigating professional relationships. Spaces for personal well-being and systemic support should also be implemented in the medical system.
The comparison of magnetic and stringed stents on stent-related symptoms and quality of life: an observational study on patient-driven choice.
Eren MT, Özveri H
BMC Urol · 2026 May · PMID 42129777 · Full text
BACKGROUND: This study compared patients with stringed versus magnetic stents regarding quality of life and stent-related discomfort throughout the stent indwelling period. The aim of this study was to assist clinicians...
BACKGROUND: This study compared patients with stringed versus magnetic stents regarding quality of life and stent-related discomfort throughout the stent indwelling period. The aim of this study was to assist clinicians in selecting the appropriate type of stent considering stent-related symptoms. METHODS: A total of 137 patients (56 females and 81 males) with ureteral stents were enrolled in the study. Pain scores using the visual analog scale (VAS) were recorded after surgery, before hospital discharge and prior to stent removal. Patients completed the Turkish-validated T-USSQ at stent removal to evaluate quality of life during stent indwelling period. RESULTS: A magnetic stent was placed in 52.6% (n = 72) of the patients while 47.4% (n = 65) of the patients had stringed stents. VAS values were comparable between the groups. Initially, univariate analysis showed significantly lower USSQ-Pain scores in the SS group (p = 0.026). However, after performing multivariate adjustment for gender and stent duration, no statistically significant differences were found between MS and SS in any USSQ subdomains or VAS scores (p > 0.05 for all). CONCLUSIONS: In this patient-selected cohort, both magnetic and stringed stents showed comparable morbidity profiles after adjusting for baseline variables. While SS may seem advantageous in univariate comparisons, these differences appear to be driven by patient demographics rather than the stent type itself.
Microgravity-Related Changes in Urinary Calcium and Oxalate Excretion: A Systematic Review of Astronaut Data.
Villanueva-Congote J, Smith S, Tinh Le T … +8 more , Karachenets S, Marin-Urrego J, Hansen N, Dalton R, James E, Buckey JC, Wollin DA, Sobel DW
Urology · 2026 May · PMID 42128230 · Publisher ↗
OBJECTIVE: To synthesize evidence on urinary calcium and oxalate in astronauts, comparing short- and long-duration missions and temporal patterns across mission phases. METHODS: Studies involving astronauts that assessed...
OBJECTIVE: To synthesize evidence on urinary calcium and oxalate in astronauts, comparing short- and long-duration missions and temporal patterns across mission phases. METHODS: Studies involving astronauts that assessed microgravity as the primary exposure and collected urine specimens were included. PubMed and EMBASE were searched using Medical Subject Headings and Emtree terms. Results were synthesized narratively, with quantitative data summarized using descriptive statistics and medians with interquartile ranges where appropriate. RESULTS: Thirty studies met the inclusion criteria, spanning early U.S. missions (Gemini, Apollo, Skylab), Russian Salyut and Mir missions, and more recent Space Shuttle and International Space Station flights. Most studies reported increased urinary calcium excretion, often peaking early in flight. Short missions showed heterogeneous and typically transient increases with rapid post-flight normalization, whereas long-duration missions demonstrated more consistent, sustained hypercalciuria with delayed recovery. Data on urinary oxalate were limited, with only 4 studies reporting in-flight measurements. CONCLUSION: Hypercalciuria during spaceflight varies by mission duration, with the highest and most consistent risk observed during long-duration mission. Oxalate metabolism remains poorly studied in astronauts. As human spaceflight advances toward exploratory-class missions, further development and testing of countermeasures targeting hypercalciuria and other urinary risk factors for nephrolithiasis are needed.
Editorial Comment on "Trends of Motor-Vehicle Related Genitourinary Trauma as Compared to Motor Vehicle Fatalities from 2012 to 2022".
Manivasagam SS
Urology · 2026 May · PMID 42119854 · Publisher ↗
Abstract loading — click title to view on PubMed.
Post Vasectomy Semen Analysis Completion in Clinic-Based Versus Mail-In Testing.
Doss M, Kraus H, Markollari G … +4 more , Salisbury S, Schlesselman C, DeFroda E, Wakefield M
Urology · 2026 May · PMID 42119853 · Publisher ↗
OBJECTIVE: To compare post-vasectomy semen analysis (PVSA) completion rates between clinic-based and mail-in testing methods following an institutional protocol change. Mail-in PVSA kits may reduce barriers associated wi...
OBJECTIVE: To compare post-vasectomy semen analysis (PVSA) completion rates between clinic-based and mail-in testing methods following an institutional protocol change. Mail-in PVSA kits may reduce barriers associated with in-person sample submission. METHODS: A retrospective review was performed to identify patients who underwent a vasectomy from January 2015 to September 2023. Outcomes included PVSA completion within 6 months, overall PVSA completion, semen analysis result, vasectomy failures, and repeat vasectomies. Chi-squared tests were used to compare categorical variables and student's t-tests to compare continuous variables. PVSA completion was further analyzed using unadjusted odds ratios and multivariable logistic regression analysis controlling baseline characteristics. RESULTS: Nine hundred sixty-six patients were included (592 clinic-based and 374 mail-based). Significantly more patients in the mail-based group had semen analysis results within 6 months (77.7% vs 83.42%, P = .0485). Overall completion rates did not differ significantly between groups (84.49% vs 80.57%, P = .101). On unadjusted analysis, mail-based testing, marital status, and travel time were associated with increased odds of 6-month PVSA completion. On multivariable analysis, only marital status and age were associated with PVSA completion. CONCLUSION: Mail-based and clinic-based PVSA demonstrated comparable adherence, with completion more strongly associated with patient age and marital status than with testing modality. These findings support mail-based PVSA as a safe and effective alternative for post-vasectomy follow-up, particularly in populations with high baseline compliance.
Clinical Outcomes of Pathologist-Guided Ex-Vivo Onco-TESE: A Single Institution Experience and Contemporary Review.
Reddy AG, Steele GL, Barros GG … +7 more , Qian Z, Kielhofner J, Pelzman DL, Clinton T, Hirsch MS, Eberhardt AB, Kathrins M
Urology · 2026 May · PMID 42119852 · Publisher ↗
OBJECTIVE: To assess the fertility outcomes of pathologist-guided ex vivo TESE of radical orchiectomy specimens, without involvement of reproductive urologist or microsurgical skills. Ex-vivo testicular sperm extraction...
OBJECTIVE: To assess the fertility outcomes of pathologist-guided ex vivo TESE of radical orchiectomy specimens, without involvement of reproductive urologist or microsurgical skills. Ex-vivo testicular sperm extraction (TESE) is a viable alternative for fertility preservation in patients with testicular cancer and concomitant azoospermia. While existing literature describes urologist-driven sperm retrieval, pathologist-driven extraction provides the opportunity to prioritize fertility outcomes in individuals while optimizing oncologic staging. METHODS: We performed a single-institution retrospective chart review of all patients who underwent radical orchiectomy for presumed testis cancer with concomitant ex-vivo TESE. Demographic, clinical, fertility, and oncologic information was extracted from the electronic medical record. RESULTS: There were 11 patients who underwent concomitant orchiectomy and ex-vivo TESE between 2016 and 2025. Successful sperm retrieval and cryopreservation occurred in 8 individuals (73%) for an average of 3.8 vials (median 5.5, IQR 2.5-7). Preoperative semen analysis, serum tumor markers, and tumor stage, size, or histology did not correlate with the likelihood of successful ex-vivo TESE. CONCLUSION: Pathologist-guided ex-vivo onco-TESE is a feasible and effective alternative to urologist-performed oncologic-TESE, achieving comparable or higher sperm retrieval rates without need for microsurgical expertise. This multidisciplinary model may expand access to fertility preservation while maintaining oncologic integrity.
Risk factors for recurrence following robot-assisted laparoscopic partial nephrectomy (RAPN): a single-center retrospective study.
Oki M, Ohba K, Matsuda T … +4 more , Mitsunari K, Matsuo T, Mochizuki Y, Imamura R
BMC Urol · 2026 May · PMID 42116100 · Full text
BACKGROUND: The recurrence rate after robot-assisted laparoscopic partial nephrectomy (RAPN) for renal cell carcinoma varies, and few established risk factors have been identified. We investigated recurrence rate and its...
BACKGROUND: The recurrence rate after robot-assisted laparoscopic partial nephrectomy (RAPN) for renal cell carcinoma varies, and few established risk factors have been identified. We investigated recurrence rate and its risk factors following RAPN. METHODS: Among 221 patients who underwent RAPN at our institution from 2016 to 2024, we analyzed 205 patients diagnosed with renal cell carcinoma (excluding benign diseases). We retrospectively examined recurrence rates and risk factors. RESULTS: Postoperative recurrence was observed in 11 cases: 3 local recurrences and 8 non-local recurrences. The postoperative recurrence rate was 5.3%. The overall median follow-up duration for the full cohort was 63.5 months and the median time to postoperative recurrence was 15 months. Regarding perioperative findings, sex, lateral perirenal fat thickness, dorsal perirenal fat thickness, tumor size, operative time, warm ischemia time, pathological tumor (pT) stage ≥ 3a, and Fuhrman grade ≥ 3 were associated with postoperative recurrence status. A Cox regression analysis for recurrence-free survival was performed on factors associated with postoperative recurrence in the univariate analysis, and hazard ratios (HRs) were calculated. In particular, it was indicated that pT stage ≥ 3a (HR: 8.2, 95% confidence interval (CI): 2.0-33.8; p < 0.01) and Fuhrman grade ≥ 3 (HR: 9.2, 95% CI: 2.5-33.8; p < 0.01) might be associated with recurrence. However, postoperative recurrence occurred in only one of the seven cases with positive surgical margins, suggesting that no significant association was detected between positive surgical margins and recurrence in this cohort. Thirty-seven (18%) patients had either pT stage ≥ 3a or Fuhrman grade ≥ 3 (high-risk group). Compared with the 169 patients in the low-risk group (i.e., neither pT stage ≥ 3a nor Fuhrman grade ≥ 3), RFS was significantly shorter in patients meeting either criterion (HR: 15.6; 95% CI: 4.1-59.9; p < 0.01). CONCLUSION: Positive surgical margin was not significantly associated with recurrence after RAPN for renal cell carcinoma, whereas pT stage ≥ 3a and Fuhrman grade ≥ 3 may be associated with recurrence. These findings should be interpreted with caution due to the limited number of events and require validation in larger studies.
Testicular histiocytic sarcoma: a case report and literature review of an uncommon histological type of urogenital malignancy.
Wei H, Cao Z, Liu Y … +4 more , Huang S, Bai T, Lyu L, Yuan J
BMC Urol · 2026 May · PMID 42116046 · Full text
BACKGROUND: Testicular tumors are relatively uncommon urogenital malignancies, accounting for only 1-2% of all cancers in men, with germ cell tumors representing the predominant histopathological subtype. Histiocytic sar...
BACKGROUND: Testicular tumors are relatively uncommon urogenital malignancies, accounting for only 1-2% of all cancers in men, with germ cell tumors representing the predominant histopathological subtype. Histiocytic sarcoma (HS) is a rare and aggressive malignancy that typically arises in extranodal sites, and its standard treatment strategy has yet to be established. Here, we report a rare case of testicular histiocytic sarcoma, which has been sparsely documented in previous studies and for which clinical experience remains limited, thereby providing valuable insights into its diagnostic challenges and clinical management. CASE PRESENTATION: This case describes a 70-year-old male admitted with enlarged left scrotum accompanied by ulceration. Based on the chief complaint, medical history, physical examination and ancillary investigation results, enhanced CT and MRI revealed patchy mixed-density shadows in the left testicular region and with obvious enhancement, which indicated the possibility of neoplastic lesion. The patient had indications for surgery and underwent orchiectomy. Histopathological and immunohistochemical evaluation confirmed a testicular histiocytic sarcoma. The postoperative recovery was uneventful and the follow-up data revealed no recurrence. CONCLUSION: Testicular histiocytic sarcoma is an uncommon type of tumor that has rarely been reported before. Its diagnosis remains challenging and the standard treatment for this disease is still undetermined. This case could provide valuable clinical experience and contribute to a more comprehensive understanding of testicular histiocytic sarcoma, and indicated surgical resection might be a feasible treatment for selected cases.
Modified lateral decubitus position with endoscopic combined intrarenal surgery for the management of complex calculi in solitary kidneys.
Su W, Tang X, Zhou Q … +7 more , Xia R, Zhang X, Zhou Z, Peng J, Tang Y, Chen X, Fu H
BMC Urol · 2026 May · PMID 42116033 · Full text
BACKGROUND: This study compared the safety and efficacy of endoscopic combined intrarenal surgery (ECIRS) and minimally invasive percutaneous nephrolithotomy (mPCNL) in the treatment of solitary kidney calculi. METHODS:...
BACKGROUND: This study compared the safety and efficacy of endoscopic combined intrarenal surgery (ECIRS) and minimally invasive percutaneous nephrolithotomy (mPCNL) in the treatment of solitary kidney calculi. METHODS: A retrospective analysis was conducted on patients with solitary kidneys and complex renal calculi treated at our center between July 2021 and December 2024. RESULTS: Twenty-eight patients underwent ECIRS, and thirty underwent mPCNL. The median operative time was significantly shorter in the mPCNL group (P<0.05), while postoperative hospital stay, drainage duration, and hemoglobin reduction were comparable between groups. The 3-month stone-free rate (SFR) was significantly higher in the ECIRS group (89.30% vs. 66.70%, P = 0.039); multivariate analysis identified surgical approach and stone volume as independent predictors of 3-month SFR. Postoperative day 1 Scr was significantly lower in the ECIRS group (P = 0.001), with surgical approach predicting immediate Scr. Overall complication rates (21.43% vs. 33.33%) showed no difference (P>0.05). CONCLUSION: Compared with mPCNL, ECIRS provides significantly higher 3‑month SFR and better perioperative renal protection in patients with solitary kidney calculi, despite longer operative time. Complication rates are comparable between the two modalities. Therefore, ECIRS represents a safe and effective minimally invasive option for complex solitary kidney stones.
Urinary adhesion molecules with ERK signaling as predictive biomarkers for kidney stones: a pilot study.
Tseng YS, Tseng HI, Chang SJ … +5 more , Ku PW, Wu JM, Lai HP, Chang TH, Lee YJ
BMC Urol · 2026 May · PMID 42116030 · Full text
BACKGROUND: Noninvasive diagnostic biomarkers should be researched to reduce the need for imaging and radiation exposure in patients with kidney stone disease. This pilot study aimed to evaluate the diagnostic potential...
BACKGROUND: Noninvasive diagnostic biomarkers should be researched to reduce the need for imaging and radiation exposure in patients with kidney stone disease. This pilot study aimed to evaluate the diagnostic potential of urinary p-ERK/t-ERK (inflammatory signaling), osteopontin, CD44, and annexin II (adhesion molecule) levels in predicting kidney stone disease. METHODS: Thirty-seven participants were enrolled: 20 with and 17 without the disease. Spot urine samples were collected for crystal count and biochemical analyses. Enzyme-linked immunosorbent assay was performed to measure p-ERK/t-ERK in urine sediment and urinary osteopontin, CD44, and annexin II levels. Pearson's correlation and receiver operating characteristic curve analyses were used to assess the correlations and diagnostic values of these biomarkers. RESULTS: The stone group showed significantly higher levels of p-ERK1/2 activity and urinary adhesion proteins (osteopontin, CD44, and annexin II) compared with those in the non-stone group. Receiver operating characteristic curve analysis revealed that these biomarkers could moderately distinguish between stone and non-stone groups. A multivariable logistic model combining CD44², ERK/CD44, and CD44/annexin II demonstrated enhanced discriminatory potential, achieving an AUC-ROC of 0.88. Additionally, annexin II levels showed a weak positive correlation with stone number and could distinguish patients with three or more stones from those with fewer. CONCLUSIONS: This is the first study to reveal the concurrent elevation of ERK-related inflammatory signaling and urinary adhesion molecules in association with kidney stone disease. These markers could serve as potential candidate biomarkers for non-invasive diagnosis and disease monitoring. Our findings offer preliminary insights into the pathophysiology of kidney stones and may aid in future diagnostic development.
Impact of Tranexamic acid in reducing intra-operative blood loss during mono-polar TURP in geriatric population: a comparative study from Pakistan - a state highly prevalent of anemia.
Shaukat Ali A, Noor H, Bilal M … +4 more , Abrar M, Liaqat K, Adrees R, Ashraf F
BMC Urol · 2026 May · PMID 42108456 · Full text
BACKGROUND: In resource-limited countries, baseline anemia is highly prevalent among elderly patients. Elderly seeking surgical intervention for prostatic enlargement (PE) often find themselves in a clinical paradox: too...
BACKGROUND: In resource-limited countries, baseline anemia is highly prevalent among elderly patients. Elderly seeking surgical intervention for prostatic enlargement (PE) often find themselves in a clinical paradox: too unfit to endure surgery without risk yet too symptomatic to maintain an acceptable quality of life without intervention as surgery increases their vulnerability to the sequential surgical blood loss. Transurethral Resection of the Prostate (TURP) remains the gold-standard surgical treatment for PE. Intra-operative hemorrhage is its most common and significant complication. Tranexamic acid (TXA) is an antifibrinolytic agent proven to reduce bleeding in trauma. Studies exhibit improved intra-operative outcomes including decreased blood loss, reduced irrigation fluid and shorter operative times. METHODOLOGY: Conducted in Allied Hospital Faisalabad, 60 patients fulfilling inclusion criteria were enrolled. Two groups were made: Group-A received a single 1 g dose of TXA before induction of anesthesia while Group-B did not. Each group was further stratified by prostate weight: Subgroups A1/B1 (40-60 g) and A2/B2 (61-80 g). All patients underwent TURP and intra-operative blood loss was quantified using hemoglobin content in irrigation fluid with blood loss calculated via a standard equation. Resection time and resected tissue weight was recorded. RESULTS: Mean prostate weight of 62 ± 10.7 g in Group-A patients and 62.5 ± 10.8 g in Group-B patients. Blood loss in TURP was 289 ± 76 ml in Group-A versus 357 ± 81 ml in Group-B. Blood loss per gram of resected tissue was 11.4 ± 1.3 ml/g in Group-A and 14 ± 2.8 ml/g in Group-B. Segregated group result shows that TXA significantly reduced blood loss and blood loss per gram specifically in the case of large prostate as compared to small ones. CONCLUSION: In our quasi-experimental trial, pre-operative single dose administration of TXA in patients undergoing monopolar TURP brings out satisfactory results. TXA significantly reduces the intra-operative blood loss and blood loss per gram along with reduction in volume of irrigating fluid and duration of surgery. The classified group results reveal that TXA acts approximately equal on large and small prostates.
Virulence genes and antimicrobial resistance profiles of Klebsiella pneumoniae isolated from urinary tract infections.
Maqsoodi M, Tajbakhsh E, Momtaz H
BMC Urol · 2026 May · PMID 42104341 · Full text
INTRODUCTION: Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen associated with urinary tract infections (UTIs) and exhibits increasing antibiotic resistance and virulence. METHODS: Ten K. pneumoniae iso...
INTRODUCTION: Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen associated with urinary tract infections (UTIs) and exhibits increasing antibiotic resistance and virulence. METHODS: Ten K. pneumoniae isolates from UTIs were analyzed for antibiotic susceptibility using the disc diffusion method and classified as multidrug-resistant (MDR) if resistant to at least three antibiotic classes. PCR was employed to detect virulence genes (mrkA, mrkD, capP, entB) and resistance determinants (blaSHV, dfrA1, tetB, aadA1, sul1, qnr). RESULTS: All isolates were resistant to tetracycline, and 80% showed resistance to ampicillin-sulbactam. Six isolates (60%) were MDR. Virulence genes mrkA and mrkD were present in 70% of isolates, while capP and entB were detected in 60%. Resistance genes blaSHV, aadA1, tetB, sul1, dfrA1, and qnr were detected in 80%, 60%, 100%, 40%, 30%, and 40% of isolates, respectively. MDR isolates generally carried more virulence factors than non-MDR isolates. CONCLUSION: Although the study involves a limited number of isolates, the coexistence of multidrug resistance and multiple virulence genes highlights the potential clinical risk of K. pneumoniae in UTIs. These findings underscore the importance of ongoing surveillance and cautious antibiotic use.
The low-grade Inflammation Score (INFLA-Score) as a predictor of overall survival in prostate cancer: a UK biobank cohort study.
Jiang S, Zheng X, Qiu H … +2 more , Tao N, An H
BMC Urol · 2026 May · PMID 42104304 · Full text
OBJECTIVE: Inflammation plays a crucial role in the progression and prognosis of prostate cancer (PCa). The aim of this study was to investigate the association of the low-grade inflammation score (INFLA-score) with over...
OBJECTIVE: Inflammation plays a crucial role in the progression and prognosis of prostate cancer (PCa). The aim of this study was to investigate the association of the low-grade inflammation score (INFLA-score) with overall survival in patients with prostate cancer. METHODS: Utilizing data from the UK Biobank, we included 13,166 men diagnosed with PCa. The predictive accuracy of systemic inflammatory biomarkers for overall survival was assessed and compared using the C-statistic. Survival curves were plotted using the Kaplan-Meier method and differences in in overall survival between groups were compared by the log-rank test. Restricted cubic spline (RCS) curves were used to explore the relationship between biomarkers and survival. Independent prognostic biomarkers associated with overall survival (OS) were determined using multivariable Cox proportional hazards regression analysis. RESULTS: The INFLA-score demonstrated the highest predictive accuracy for overall survival among all evaluated biomarkers, with a C-statistic of 0.556 (0.544,0.567). Patients with a high INFLA-score had significantly worse overall survival (shorter survival time) than those with a low INFLA-score (33.76% vs. 66.24%; log-rank p < 0.001). RCS analysis revealed a significant dose-response relationship between the INFLA-score and survival in PCa patients. After adjusting for potential confounders, a high INFLA-score remained an independent predictor of poor OS (HR = 1.24, 95% CI: 1.15-1.33, p < 0.001). CONCLUSIONS: The INFLA-score was independently associated with overall survival of PCa patients. As an easily obtainable and integrative measure of low-grade inflammation, it shows significant promise for clinical application in risk stratification and survival prediction.
Effects of vacuum-assisted access sheath in mini-percutaneous nephrolithotomy on early postoperative pain and analgesic requirement: a retrospective analysis.
Biçer H, Kölükçü V
BMC Urol · 2026 May · PMID 42104286 · Full text
BACKGROUND/OBJECTIVES: This study aimed to evaluate the effect of vacuum-assisted access sheath use during mini-percutaneous nephrolithotomy (mini-PCNL) on early postoperative pain intensity and analgesic requirements in...
BACKGROUND/OBJECTIVES: This study aimed to evaluate the effect of vacuum-assisted access sheath use during mini-percutaneous nephrolithotomy (mini-PCNL) on early postoperative pain intensity and analgesic requirements in the treatment of renal pelvic stones. METHODS: A total of 150 patients who underwent mini-PCNL for a single renal pelvic stone ≥ 20 mm were retrospectively included. Patients who underwent standard mini-PCNL were classified as Group 1, while those treated with a vacuum-assisted access sheath were assigned to Group 2. Demographic characteristics, perioperative parameters, pain assessed by visual analog scale (VAS), and analgesic requirements were compared between the groups. RESULTS: The two groups were comparable in terms of mean age, body mass index, comorbidity status, ASA scores, degree of hydronephrosis, distance between skin puncture, fluoroscopy time, stone size, and stone density (p > 0.05). Operative time and length of hospital stay were significantly longer in Group 1 (77.97 ± 15.72 min and 3.28 ± 1.56 days, respectively) compared with Group 2 (p < 0.001). The incidence of high-grade fever and urinary tract infections requiring additional antibiotic therapy was significantly higher in Group 1 (p = 0.044 and p = 0.032, respectively). Hemoglobin decrease was also more pronounced in Group 1 (p < 0.001). Postoperative VAS scores were significantly lower in Group 2 than in Group 1 (p < 0.001). The absolute between-group differences in VAS at rest were 1.37 points at 1 h, 1.68 points at 6 h, and 1.81 points at 24 h. For dynamic VAS, the corresponding absolute differences were 2.38, 2.09, and 2.05 points, respectively. Furthermore, the number of patients requiring rescue analgesia was markedly higher in Group 1 (p < 0.001). In addition, Group 1 demonstrated a shorter mean time to rescue analgesia and higher analgesic dosage compared with Group 2 (p = 0.002 and p = 0.019, respectively). In multivariate analysis, vacuum-assisted access sheath use remained an independent predictor of both lower postoperative pain scores and reduced analgesic requirement, with an approximately 90% reduction in the odds of rescue analgesia use after adjustment for operative time and intraoperative remifentanil consumption. CONCLUSION: Vacuum-assisted access sheath use was associated with lower early postoperative pain scores and reduced analgesic requirements; however, prospective controlled studies are needed to confirm these findings.
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