BMC Urology[JOURNAL]
Sun
200 papers
The role of microRNAs-23b and 27b in migration, invasion and proliferation of T24 bladder cancer cells.
Fakhouri F, Candido P, Pimenta R … +7 more , Guimarães VR, Nebó G, Passerotti C, da Silva CE, Nahas WC, Leite KRM, Reis ST
BMC Urol · 2026 Jul · PMID 42401923 · Full text
BACKGROUND: Bladder cancer (BC) is the sixth most common cancer among men worldwide and represents a significant cause of morbidity and mortality. High-grade BC is associated with an increased risk of progression to musc...
BACKGROUND: Bladder cancer (BC) is the sixth most common cancer among men worldwide and represents a significant cause of morbidity and mortality. High-grade BC is associated with an increased risk of progression to muscle-invasive and metastatic disease, negatively impacting patient prognosis. Despite advances in molecular characterization, therapeutic strategies remain limited, and the identification of novel molecular targets is essential. MicroRNAs (miRNAs) are small non-coding RNAs involved in post-transcriptional gene regulation and play critical roles in tumor development and progression. Among them, miRNA-23b and miRNA-27b have been implicated in several malignancies; however, their functional role in high-grade BC remains incompletely understood. This study aimed to evaluate the expression levels of miRNAs-23b and 27b in a high-grade BC cell line and to investigate their effects on cell migration, invasion, and proliferation, exploring their potential therapeutic relevance. METHODS: The high-grade BC T24 cell line was used. Cells were divided into four groups: Control (no transfection), negative control (Scramble), miRNA-23b mimic, and miRNA-27b mimic. Relative miRNA expression levels were determined by quantitative polymerase chain reaction (qPCR). Functional assays included wound healing (migration), Matrigel invasion assay, and colony formation assay (proliferation). Statistical analyses were performed to compare groups, and p-values < 0.05 were considered statistically significant. RESULTS: Transfection resulted in significant overexpression of miRNA-23b and miRNA-27b compared to both Scramble (p = 0.0344 and p = 0.0386, respectively) and Control groups (p = 0.0343 and p = 0.0390, respectively). Both miRNA-23b and miRNA-27b significantly reduced cell migration compared to Scramble (p = 0.0286). Additionally, miRNA-23b significantly decreased invasion compared to Scramble and Control (p < 0.0001), with similar findings observed for miRNA-27b (p < 0.0001). No statistically significant differences were observed in colony formation among groups. CONCLUSIONS: Overexpression of miRNA-23b and miRNA-27b significantly reduced migration and invasion in a high-grade BC cell line, without affecting proliferation. These findings suggest that both miRNAs may act as tumor suppressors in high-grade BC and represent promising candidates for future therapeutic development in bladder cancer.
Information quality and reliability of pheochromocytoma-related videos on tiktok and Kwai: a cross-sectional study.
Luo J, Chen Z, Cao R … +1 more , Wang K
BMC Urol · 2026 Jul · PMID 42399874 · Full text
BACKGROUND: Short-video platforms are major sources of health information, yet the quality of pheochromocytoma-related content is unclear. We assessed and compared the quality and reliability of related videos on TikTok...
BACKGROUND: Short-video platforms are major sources of health information, yet the quality of pheochromocytoma-related content is unclear. We assessed and compared the quality and reliability of related videos on TikTok and Kwai. METHODS: Using the Chinese keyword "," we searched TikTok and Kwai (24-25 Dec 2025) with a newly created account and retrieved the first 120 videos from each platform under the default "comprehensive" ranking. After exclusions, 178 videos were included (TikTok, n = 100; Kwai, n = 78). Video metrics, uploader characteristics, and content features were extracted. Quality and reliability were assessed using GQS (1-5) and mDISCERN (0-5) by two blinded reviewers, with disagreements resolved by a third reviewer. We compared video characteristics and GQS/mDISCERN scores between TikTok and Kwai, and performed subgroup analyses by uploader identity and physician specialty. Nonparametric tests and Spearman correlation analyses were conducted using R 4.1.3. RESULTS: Median video length was 73.0 s; median GQS and mDISCERN were both 2.0, indicating generally low quality and reliability. Most videos were posted by healthcare personnel (81.5%), predominantly urologists (50.6%). TikTok videos were longer and had higher likes, comments, and collections (all P < 0.001). mDISCERN was higher on TikTok (P = 0.047), while GQS did not differ (P = 0.580). Video length correlated with GQS (r = 0.46) and mDISCERN (r = 0.41), whereas engagement metrics were not reliable proxies for credibility. CONCLUSIONS: Pheochromocytoma-related short videos on TikTok and Kwai show limited quality and reliability despite professional authorship. Improvements should prioritize verifiable sources and decision-relevant risk framing, supported by platform-level quality labeling and distribution strategies.
Virtual reality-based 3D prostate models for robot-assisted radical prostatectomy: a prospective exploratory study of membranous urethral length and early urinary continence recovery.
Azhar RA, Albarakaty AM, Saikali S … +1 more , Elkoushy M
BMC Urol · 2026 Jul · PMID 42399872 · Full text
OBJECTIVES: To prospectively explore the feasibility and histopathological concordance of virtual reality (VR)-based 3D prostate models in robot-assisted radical prostatectomy (RARP) and to evaluate the association betwe...
OBJECTIVES: To prospectively explore the feasibility and histopathological concordance of virtual reality (VR)-based 3D prostate models in robot-assisted radical prostatectomy (RARP) and to evaluate the association between VR-derived membranous urethral length (MUL) and early urinary continence recovery. METHODS: VR-based 3D prostate models were generated for 35 patients with localized prostatic adenocarcinoma who underwent RARP. Tumor localization, extraprostatic extension (EPE), and seminal vesicle invasion (SVI) on the 3D models were compared with the final histopathology using Cohen's kappa coefficient and standard diagnostic accuracy measures. Urinary continence was assessed using the Expanded Prostate Cancer Index Composite (EPIC) survey, with social continence defined as the use of no pads or one safety pad per day and complete continence defined as zero pad use. Continence recovery was evaluated at 1, 3, and 6 months. RESULTS: The mean patient age in the cohort was 63.2 years, the mean prostate-specific antigen (PSA) concentration was 13.36 ng/mL, and the mean prostate volume was 52.7 cc. Nerve-sparing surgery was performed in 74.3% of the patients, and extended pelvic lymph node dissection was performed in 20%. Pathologic stage ≥T3a occurred in 45.7% of patients, with a Gleason score ≤ 7 in 71.4%, an SVI in 14.3%, and positive margins in 2.9%. Perioperative complications were minimal (5.7%), with no transfusions. Continence recovery occurred in 85.7% of the patients at 3 months and 91.4% at 6 months. MUL correlated negatively with pad use at 3 months (Spearman's ρ = - 0.52), and a 14-mm MUL cutoff was associated with early continence recovery (AUC = 0.86). VR 3D models showed almost perfect agreement with the final histopathology for extraprostatic extension (EPE) (κ = 0.88; accuracy 94.3%) and perfect agreement for SVI (κ = 1.00). CONCLUSIONS: VR-based 3D prostate models may represent a useful adjunct for surgical planning in RARP and could help inform nerve-sparing strategies. MUL, as measured by these models, may be a valuable factor associated with early urinary continence recovery. These exploratory findings should be interpreted with caution and require confirmation in larger, multicenter prospective studies with longer follow-up periods.
Early urinary decompression and mortality in septic obstructing ureteral stones: a nationwide comparative-effectiveness study.
Dogha MM, Hassan AA, Mohamed OM … +7 more , Farag M, Nouh IS, Ibrahim MH, Mesbah AA, Elebiary MF, Abdelkhalek NA, Moalwi A
BMC Urol · 2026 Jul · PMID 42399868 · Full text
BACKGROUND: Septic obstructing ureteral stones are a time-critical urological emergency. Although urgent drainage is recommended, uncertainty persists regarding the comparative effectiveness of decompression strategies a...
BACKGROUND: Septic obstructing ureteral stones are a time-critical urological emergency. Although urgent drainage is recommended, uncertainty persists regarding the comparative effectiveness of decompression strategies and the influence of timing in real-world practice. METHODS: We analyzed adults with sepsis or septic shock and obstructing ureteral stones (n = 9,172) from the U.S. HCUP National Inpatient Sample (2016-2022). Exposures included any decompression (ureteral stent or percutaneous nephrostomy [PCN]) versus conservative care, and decompression timing (same-day [day 0] vs. ≥ day 1; ≤ 24 h vs. > 24 h). The primary outcome was in-hospital mortality; secondary outcomes were acute kidney injury (AKI), mechanical ventilation, dialysis, and length of stay. Adjusted associations were estimated using propensity score matching, overlap weighting, instrumental variable (IV) analysis, and landmark/time-dependent survival models with a prespecified 12-variable adjustment set. RESULTS: Overall mortality was 2.5%. Decompression was associated with lower mortality than conservative care (1.6% vs. 4.0%; risk difference - 2.4% [95% CI - 3.2 to - 1.7]; number needed to treat ≈ 41). Late decompression (> 24 h) versus early (≤ 24 h) was associated with higher odds of mortality (OR 2.17 [1.38-3.41]), AKI, ventilation, and dialysis. In exploratory analyses among decompressed patients, PCN showed higher adjusted mortality than stenting (5.5% vs. 2.8%; OR 2.05 [1.31-3.09]); IV results were directionally consistent but likely reflect residual confounding by indication and feasibility. CONCLUSION: Urgent decompression, particularly within 24 h, was associated with lower in-hospital mortality and fewer organ-failure outcomes. Modality differences should be interpreted as hypothesis-generating; PCN remains essential when retrograde stenting is not feasible.
Quality of services and patient reported outcomes for prostate cancer in Tanzania: the role of patients' satisfaction from a cross-sectional study.
Nyongole O, Munishi C, Kimu N … +13 more , Shirima GV, Sangeda RZ, Mseti M, Lugina E, Kiwara F, Sirili N, Chacha F, Nicholaus B, Mruma H, Frumence G, Simba D, Urassa D, Sunguya B
BMC Urol · 2026 Jul · PMID 42393670 · Full text
BACKGROUND: The increasing global burden of prostate cancer challenges the quality of services in low- and middle-income countries (LMICs) due to infrastructure and limitations in human resources for health. Higher quali...
BACKGROUND: The increasing global burden of prostate cancer challenges the quality of services in low- and middle-income countries (LMICs) due to infrastructure and limitations in human resources for health. Higher quality of services as perceived by patients, is associated with improved health-related quality of life (HRQoL). This study was designed to assess patients' satisfaction with the quality of services and its association with HRQoL among prostate cancer patients. METHODS: The hospital-based cross-sectional study was conducted among 248 systematically sampled prostate cancer patients under treatment from five tertiary hospitals in Tanzania. The standard patient satisfaction questionnaire and the Expanded Prostate Cancer Index Composite (EPIC) were used to measure HRQoL. Descriptive analysis was used to determine levels and characteristics of patients' satisfaction with quality of services and HRQoL, while regression analysis was conducted to examine the association between patients' satisfaction and HRQoL. RESULTS: Of the sampled prostate cancer patients, 169 (68.3%) experienced delays in seeking treatment, and a high proportion (85.4%) presented with clinically advanced stage of prostate cancer. Two-thirds of the patients were not satisfied with the quality of services. Key areas of dissatisfaction included long waiting times (75.4%), limited counselling services (77.4%), and a lack of opportunity to discuss their problems with doctors (67.3%). The overall HRQoL score was low (36 out of 60 score), with sexual domain scoring the lowest (5.81%). A unit increase in patient satisfaction was associated with five-times increase in HRQoL β-coefficient 5.25 95%, CI (2.42, 8.08). CONCLUSIONS: Patient satisfaction is a primary driver of health-related quality of life, suggesting that system-level improvements are more vital for patients reported outcomes than biological factors alone. Improving these outcomes requires targeted policy shifts, decentralized care, and stronger financial protections for patients. Key areas of improvements include waiting time and tailored counselling services.
The relationship between premature ejaculation and depressive symptoms in HIV-infected men: a multicenter case-control study.
Evlice O, Bülbül E, Üstün F … +4 more , Deniz M, Basutçu A, Şahinoğlu S, Arslan Y
BMC Urol · 2026 Jul · PMID 42393646 · Full text
BACKGROUND: Depressive symptoms are common among people living with HIV (PLWH) and may adversely affect sexual function. However, the relationship between HIV infection and premature ejaculation (PE) has not been clearly...
BACKGROUND: Depressive symptoms are common among people living with HIV (PLWH) and may adversely affect sexual function. However, the relationship between HIV infection and premature ejaculation (PE) has not been clearly defined. This study aimed to evaluate depressive symptoms in HIV-infected men and investigate their association with PE. METHODS: This multicenter case-control study included 112 HIV-infected men and 110 age-matched healthy controls who presented to infectious diseases outpatient clinics between March and September 2025. All participants completed the Turkish validated versions of the Premature Ejaculation Diagnostic Tool (PEDT) and the Beck Depression Inventory (BDI). PE was defined as a PEDT score ≥ 11. RESULTS: The mean age of PLWH was 36.3 ± 11.9 years, compared with 39.6 ± 10.8 years in the control group. Both PEDT and BDI scores were significantly higher in PLWH than in controls (p < 0.001 for both). PE was present in 49 (43.8%) HIV-infected men and 23 (20.9%) controls (p < 0.001). Among PLWH, those with PE had significantly higher BDI scores than those without PE (16.8 ± 10.1 vs. 10.7 ± 8.9, p = 0.009). In multivariable logistic regression analysis, BDI score remained independently associated with PE after adjustment for erectile function, age, and disease duration. CONCLUSIONS: HIV-infected men demonstrated higher rates of PE and more severe depressive symptoms compared with healthy controls. Among PLWH, depressive symptom severity remained significantly associated with PE after adjustment for erectile function, age, and disease duration.
The "perfect storm" in bladder oncology: a case of diverticular carcinoma with plasmacytoid features and its clinical ramifications.
Fan Q, Fu Z, Zheng X … +1 more , Wang G
BMC Urol · 2026 Jul · PMID 42393617 · Full text
BACKGROUND: Carcinoma arising within a bladder diverticulum is a rare and diagnostically challenging entity. Its management is further complicated by aggressive histological variants such as plasmacytoid urothelial carci...
BACKGROUND: Carcinoma arising within a bladder diverticulum is a rare and diagnostically challenging entity. Its management is further complicated by aggressive histological variants such as plasmacytoid urothelial carcinoma (PUC). The anatomical lack of muscularis propria in diverticula predisposes to early extra‑diverticular spread and impedes accurate clinical staging. The coexistence of a diverticular location and plasmacytoid histology creates a high‑risk clinical scenario with limited evidence to guide therapy. CASE PRESENTATION: A 74‑year‑old male with a history of high‑grade urothelial carcinoma, previously treated with transurethral resection and two cycles of neoadjuvant chemotherapy (gemcitabine plus cisplatin), was found on imaging to have a persistent tumor within a right‑sided bladder diverticulum. He underwent robot‑assisted laparoscopic radical cystectomy. Histopathological examination confirmed high‑grade PUC with 40% squamous differentiation. The tumor invaded peridiverticular adipose tissue (pT3a) and exhibited extensive lymphovascular invasion (> 10 vessels). Immunohistochemistry was positive for GATA3 (weak), p63, CD138 (partial), and CK7 (weak positivity), with PD‑L1 expression (Combined Positive Score = 5), Focal weak membranous E-cadherin staining in approximately 30% of tumor cells, HER2 equivocal (2+). Surgical margins and lymph nodes were negative. The patient was disease‑free at the 3‑month postoperative follow‑up. However, 5 months after surgery, pelvic MRI revealed metastatic lesions, consistent with stage IV disease (rT0N+M1). He subsequently received palliative radiotherapy to the pelvis (200 cGy×25f) and combined targeted therapy (disitamab vedotin 120 mg) plus immunotherapy (toripalimab 240 mg). At the last follow‑up in May 2026 (approximately 7 months postoperatively), he was clinically stable without severe symptoms and continued outpatient radiotherapy. CONCLUSION: This case highlights the diagnostic and therapeutic complexities of managing high‑grade PUC within a bladder diverticulum. It underscores the essential role of high‑quality cross‑sectional imaging for assessing extra‑diverticular extension, the need for meticulous pathological evaluation to identify this aggressive variant, and the centrality of radical surgery. The presence of lymphovascular invasion and PD‑L1 expression supports the consideration of multimodal strategies and close surveillance. Given the rarity of this dual‑pathology entity, collaborative reporting is crucial to optimize management and improve outcomes.
A comparative study of robot-assisted laparoscopic radical cystectomy combined with urinary diversion: preoperative indicators and survival outcomes analysis at a single center.
Liu C, Zhu Y, Liao Y … +3 more , Yang X, Zhao C, Zhang N
BMC Urol · 2026 Jul · PMID 42393607 · Full text
OBJECTIVE: To compare the preoperative indexes and survival outcomes between da Vinci robot-assisted radical cystectomy (RARC) and laparoscopic radical cystectomy (LRC), and to analyze the clinical differences among the...
OBJECTIVE: To compare the preoperative indexes and survival outcomes between da Vinci robot-assisted radical cystectomy (RARC) and laparoscopic radical cystectomy (LRC), and to analyze the clinical differences among the three types of urinary diversion modalities, namely, intracorporeal ileal neobladder (Studer type), Bricker's procedure, and ureterocutaneostomy. METHODS: A total of 194 patients who underwent minimally invasive radical cystectomy in the Department of Urology of the Affiliated Hospital of Zunyi Medical University from January 2010 to December 2024 were retrospectively analyzed and divided into the laparoscopic group (152 patients) and the robotic group (42 patients) according to surgical modalities. Perioperative indexes and survival outcomes of the two groups were compared, and the clinical differences among the three urinary diversion modalities were analyzed. RESULTS: The duration of surgery was significantly shorter in the robotic group than in the laparoscopic group (5.17 h vs. 6.75 h, P<0.001), but there was no significant difference in overall survival and complication rates between the two groups. Among the urinary diversion modalities, the median survival was the longest in the intracorporeal ileal neobladder group (55 months), which was significantly better than that of the Bricker procedure (25 months) and ureterocutaneostomy (13 months) (P<0.001). Multifactorial analysis showed that elevated ASA classification (HR=14.99-20.16) and male gender (HR=1.96) were independent risk factors in the laparoscopic group, whereas prolonged operative duration was associated with a reduced risk (HR=0.56). In patients with the Bricker procedure, ASA classification (P=0.001) and gender (P=0.032) significantly influenced prognosis. CONCLUSION: Robot-assisted radical cystectomy (RARC) has significant short-term surgical advantages over laparoscopic radical cystectomy (LRC). Among different urinary diversion methods, intracorporeal ileal neobladder is associated with longer survival, although this largely reflects patient selection bias. The choice of specific surgical approach should be based on a comprehensive consideration of the patient's individual circumstances.
Effects of pre-procedural video education and intra-procedural virtual reality on anxiety and pain during flexible cystoscopy: a randomized controlled trial.
Beyatlı M, Güngör HS, Sobay R … +8 more , İnkaya A, Şişik NM, Topçu ME, Evci MU, Uzel T, Suçeken FY, Tahra A, Küçük EV
BMC Urol · 2026 Jul · PMID 42380921 · Full text
BACKGROUND: This study aimed to investigate the effects of pre-procedural video education and intra-procedural distraction using virtual reality (VR) nature videos on patient anxiety and pain perception during office-bas...
BACKGROUND: This study aimed to investigate the effects of pre-procedural video education and intra-procedural distraction using virtual reality (VR) nature videos on patient anxiety and pain perception during office-based flexible cystoscopy. METHODS: In this single-center, four-arm, parallel-group randomized controlled trial, 240 adult patients scheduled for flexible cystoscopy were enrolled. Participants were randomized into four groups: Video + VR- (n = 60), Video + VR + (n = 60), Video- VR + (n = 60), and Video- VR- (control, n = 60). Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI), and pain was measured with a visual analog scale (VAS). Intergroup comparisons were performed using nonparametric tests, and outcome assessors were blinded to group allocation. RESULTS: Pain scores differed significantly among groups (H = 44.604, p < 0.001). The lowest pain scores were observed in the Video + VR + group (4.3 ± 1.1), while the highest were in the control group (5.7 ± 1.1). Reductions in STAI-S (state anxiety) scores also showed significant group differences (H = 28.311, p < 0.001). Compared with the control group, the Video + VR + group demonstrated significant improvements in both VAS (p < 0.001, r = 0.610) and STAI-S reduction (p < 0.001, r = -0.493), with large effect sizes. Analyses based on baseline STAI-T (trait anxiety) scores indicated that the interventions were effective regardless of initial anxiety levels, with the combined Video + VR + approach consistently providing the greatest benefit. CONCLUSION: The combination of pre-procedural video education and intra-procedural VR distraction was associated with the greatest reduction in pain and anxiety during flexible cystoscopy. These findings support the potential value of multimodal approaches for improving patient comfort during urologic procedures. TRIAL REGISTRATION: Registered on 05 September 2025 in the ISRCTN registry (ISRCTN22513446).
Can social media videos meet patients' information needs for benign prostatic hyperplasia? A repeated cross-sectional study.
Tian C, Wang W, Tao J … +2 more , Luo G, Zhou J
BMC Urol · 2026 Jun · PMID 42366358 · Full text
BACKGROUND: Benign prostatic hyperplasia (BPH) is a common urological condition among older men and can cause lower urinary tract symptoms (LUTS). As patients increasingly seek disease-related information through social...
BACKGROUND: Benign prostatic hyperplasia (BPH) is a common urological condition among older men and can cause lower urinary tract symptoms (LUTS). As patients increasingly seek disease-related information through social media, evaluations of the quality, reliability, and transparency of patient-facing BPH content remain limited. METHODS: Repeated cross-sectional searches were conducted on Bilibili and TikTok on December 1, 16, and 31, 2025. Basic video characteristics were extracted. Video reliability, quality, and transparency were assessed using the modified DISCERN (mDISCERN), Global Quality Score (GQS), and the Journal of the American Medical Association (JAMA) benchmark criteria, respectively. Exploratory supplementary assessments of content coverage and accessibility-related features were conducted using the content coverage checklist (CCC) and video accessibility checklist (VAC). Potentially misleading or harmful information signals were also descriptively assessed. Spearman correlation analysis and ordinal logistic regression were performed to examine associations between video characteristics and assessment scores. RESULTS: A total of 217 videos were included. Overall, the median (IQR) scores were 3.00 (2.00-3.00) for mDISCERN, 3.00 (2.00-3.00) for GQS, and 2.00 (2.00-2.00) for JAMA. In exploratory supplementary analyses, the median (IQR) scores were 3.00 (2.00-4.00) for CCC and 6.00 (5.00-6.00) for VAC. Potentially misleading or harmful information signals were observed in 29 videos (13.4%). Videos published by professional individuals and professional institutions had significantly higher mDISCERN, GQS, and JAMA scores than those published by non-professional individuals (all P < 0.001). Spearman correlation analysis and ordinal logistic regression indicated that engagement metrics were not independent predictors of assessment scores. CONCLUSIONS: Overall, BPH-related videos on social media showed moderate reliability, quality, and transparency, but consistently high-value content remained limited. A minority of videos also contained potentially misleading or harmful information signals. Videos from professional sources tended to provide higher-quality information, whereas user engagement was not a reliable indicator of content quality. These findings suggest that urologists and healthcare institutions may have an important role in providing more structured, understandable, and patient-oriented digital education for men seeking BPH information online.
Outcomes in patients undergoing benign prostatic hyperplasia surgical re-treatment with holmium laser enucleation of the prostate compared to treatment-naïve patients.
Guo J, McDevitt JW, Peterson JT … +4 more , Patel A, Khondakar N, Xu P, Krambeck A
BMC Urol · 2026 Jun · PMID 42351164 · Full text
BACKGROUND: Minimally invasive surgical therapies for benign prostatic hyperplasia (BPH) are increasingly utilized but may have limited long-term durability, leading some patients to require re-treatment. Holmium laser e...
BACKGROUND: Minimally invasive surgical therapies for benign prostatic hyperplasia (BPH) are increasingly utilized but may have limited long-term durability, leading some patients to require re-treatment. Holmium laser enucleation of the prostate (HoLEP) is a size-independent option, but outcomes after prior BPH intervention remain incompletely characterized. We compared perioperative, postoperative, and functional outcomes of HoLEP in re-treatment versus treatment-naïve HoLEP. METHODS: We performed a retrospective cohort study of patients undergoing HoLEP at a tertiary center between February 2021 and August 2025. Patients with prior surgical or minimally invasive BPH interventions were propensity score-matched 1:1 to treatment-naïve patients by prostate specimen weight. Perioperative variables, postoperative outcomes, and functional measures were compared. RESULTS: We identified 418 re-treatment patients who were matched to 418 treatment-naïve controls. Re-treatment patients were older and had higher rates of prior urinary retention and urinary tract infection. Operative time, laser energy usage, and intraoperative complication rates were similar between cohorts. Overall, 90-day complication rates did not differ (6.5% vs. 5.5%, p = 0.66), though emergency department visits were more frequent in re-treatment patients (9.1% vs. 5.3%, p = 0.044). Both groups experienced comparable improvements in American Urological Association symptom and quality of life scores. Postoperative Michigan Incontinence Symptom Index severity scores were lower in the re-treatment cohort (4.9 ± 6.1 vs. 6.4 ± 6.5, p = 0.038). CONCLUSIONS: HoLEP performed after prior BPH intervention demonstrates perioperative safety and functional outcomes comparable to treatment-naïve HoLEP, supporting its role as a durable and effective treatment for recurrent or persistent BPH symptoms.
Robot-assisted versus laparoscopic partial nephrectomy for multiple ipsilateral renal tumours: surgical, functional and oncological outcomes.
Shi C, Peng C, Song J … +7 more , Wang L, Lv D, Chen Y, Cao S, Chen X, Ma X, Huang Q
BMC Urol · 2026 Jun · PMID 42343251 · Full text
BACKGROUND: This study aimed to compare the outcomes of laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) for the treatment of multiple ipsilateral renal tumours (MIRT). The primary out...
BACKGROUND: This study aimed to compare the outcomes of laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) for the treatment of multiple ipsilateral renal tumours (MIRT). The primary outcomes were perioperative results, including the rate of postoperative complications and 'Trifecta' achievement. The secondary outcomes included renal functional preservation and oncological survival. METHODS: We retrospectively analysed the data of patients with MIRT who underwent LPN or RAPN between 2010 and 2024. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, resulting in a final matched cohort of 19 patients per group. Perioperative data and functional, oncological, and survival outcomes were reviewed. RESULTS: In the matched cohort, the RAPN group was associated with significantly fewer postoperative complications (10.5% vs. 47.4%, P = 0.029). Notably, 88.9% (8/9) of the complications in the LPN group were Clavien-Dindo grade I. The RAPN group also showed a higher 'Trifecta' rate (63.2% vs. 21.1%, P = 0.020) and shorter postoperative hospital stay (4 vs. 6 days; P = 0.044). At 12 months postoperatively, the RAPN group demonstrated significantly lower absolute (9.1 vs. 18.4 µmol/L, P = 0.041) and percentage changes (12.0% vs. 25.9%, P = 0.024) in serum creatinine (Scr). No significant differences were identified in disease-free survival (P = 0.386), cancer-specific survival (P = 0.678), or overall survival (P = 0.116). CONCLUSIONS: For patients with MIRT, RAPN demonstrates superior perioperative results and better preservation of renal function compared to LPN. These findings support the use of robotics as the preferred minimally invasive strategy for complex cases with two ipsilateral renal lesions, potentially enhancing surgical safety and functional outcomes.
Variant histology in urothelial carcinoma: associated factors and survival impact after radical cystectomy.
Uzun E, Ozen S, Senel S … +6 more , Arabaci HB, Koudonas A, Gultekin H, Kizilkan Y, Ceylan C, Ozden C
BMC Urol · 2026 Jun · PMID 42337550 · Full text
PURPOSE: To investigate the factors associated with variant histology (VH) and prognostic significance of VH in urothelial carcinoma (UC) among patients undergoing radical cystectomy (RC) with ileal conduit urinary diver...
PURPOSE: To investigate the factors associated with variant histology (VH) and prognostic significance of VH in urothelial carcinoma (UC) among patients undergoing radical cystectomy (RC) with ileal conduit urinary diversion. METHODS: A retrospective analysis was conducted on 317 patients who underwent RC with ileal conduit diversion between 2019 and 2025. Patients were categorized based on the presence of VH in the final pathology. Demographic, clinical, perioperative, and pathological data were compared. Logistic regression was performed to identify factors associated with VH, while Kaplan-Meier and uni-multivariable Cox regression analyses evaluated overall survival (OS) and cancer-specific survival (CSS). RESULTS: VH was detected in 139 patients (43.8%), with squamous differentiation being the most prevalent variant, observed in 80 patients of the 317 patients who underwent RC with ileal conduit urinary diversion. Presence of hydronephrosis, clinical lymph node positivity and WBC > 7695 g/dl were defined as factors associated with VH in multivariate logistic regression analysis. Kaplan-Meier survival analysis illustrated a statistically significant reduction in OS and CSS among patients harboring VH compared to those with pure UC following RC and ileal conduit urinary diversion (53.8 vs. 36.8 months for OS and 68 vs. 53 months for CSS, log-rank test, p < 0.001). Multivariable Cox regression analysis revealed that presence of variant histology was associated with reduced OS (HR = 1.624; 95% CI = 1.094-2.411; p = 0.016) and CSS (HR = 1.945; 95% CI = 1.043-3.626; p = 0.036). CONCLUSION: VH in UC is associated with advanced disease and poorer survival outcomes following RC. Certain preoperative factors-hydronephrosis, clinical lymphadenopathy, and elevated WBC-may be associated with the presence of VH. Early recognition of these features could guide individualized treatment strategies and improve prognostic assessment. However, the retrospective and single-center nature of this study may introduce selection and information bias, and the findings should be interpreted with caution until validated by prospective multicenter trials.
Unilateral primary adrenal high-grade B-cell lymphoma treated with R-CHOP chemotherapy: a case report and literature review.
Suçeken FY, İhvan AN, Arslan A … +1 more , Keski H
BMC Urol · 2026 Jun · PMID 42332622 · Full text
BACKGROUND: Primary adrenal lymphoma (PAL) is a rare and aggressive extranodal lymphoma that may radiologically mimic primary adrenal carcinoma, often leading to diagnostic uncertainty and potentially unnecessary surgica...
BACKGROUND: Primary adrenal lymphoma (PAL) is a rare and aggressive extranodal lymphoma that may radiologically mimic primary adrenal carcinoma, often leading to diagnostic uncertainty and potentially unnecessary surgical intervention. Early tissue diagnosis is essential for accurate management. CASE PRESENTATION: A 71-year-old man was evaluated for persistent left upper quadrant abdominal pain and progressive fatigue. Cross-sectional imaging revealed a large, heterogeneous mass originating from the left adrenal gland with radiologic features suggestive of local invasion. Based on the initial radiologic impression, primary adrenal carcinoma was suspected, and surgical intervention was planned accordingly. However, further review by an experienced radiologist raised suspicion of a lymphoproliferative disorder. A computed tomography-guided core needle biopsy was subsequently performed, and histopathological analysis confirmed the diagnosis of high-grade B-cell lymphoma with a Ki-67 proliferation index of approximately 80%. The patient received six cycles of well-tolerated R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Post-treatment imaging revealed complete resolution of the adrenal mass. At the 24-month follow-up, the patient remained in complete remission, with no evidence of disease recurrence. CONCLUSIONS: This case underscores the importance of multidisciplinary assessment and image-guided biopsy in the evaluation of adrenal masses. Avoiding unnecessary surgery through early tissue diagnosis enabled effective systemic treatment. In selected patients, R-CHOP chemotherapy may result in long-term disease control, even in elderly individuals with large unilateral adrenal tumors.
Purple catheter syndrome (PUBS): a mystery in a post stroke patient with Klebsiella - should we be concerned?
Induja K, Gaur R, Gonnade NM … +4 more , Tak V, Sinha KK, Sheenam N, T K A
BMC Urol · 2026 Jun · PMID 42323651 · Full text
BACKGROUND: Purple urine bag syndrome (PUBS) is an unusual but recognizable manifestation characterized by a striking purple hue in the urinary collection system. This phenomenon results from bacterial enzymatic breakdow...
BACKGROUND: Purple urine bag syndrome (PUBS) is an unusual but recognizable manifestation characterized by a striking purple hue in the urinary collection system. This phenomenon results from bacterial enzymatic breakdown of tryptophan in the presence of alkaline urine. While often benign, PUBS can indicate an underlying infection, particularly in individuals with long-term catheterization and other risk factors, such as immobility and constipation. CASE PRESENTATION: We describe the case of a woman in her 40s with a prior cerebrovascular accident who was bedbound and dependent on a long-term indwelling catheter. She developed discoloration of her urine bag without systemic symptoms. Urine analysis revealed an alkaline pH and significant pyuria, and culture confirmed infection with Klebsiella pneumoniae. Management involves replacing the catheter, initiating culture-directed antibiotic therapy with levofloxacin, optimizing bowel habits, and promoting hydration. These interventions led to a full resolution of the discoloration and infection. CONCLUSION: Although visually alarming, PUBS often serves as a subtle clinical indicator of underlying urinary tract pathology. This case highlights the necessity of a multifactorial management approach, including microbiological evaluation, catheter hygiene, bowel regulation, and patient education. Early recognition of PUBS may help prevent escalation to more severe complications in vulnerable, catheter-dependent patients.
Evaluation of ChatGPT-4o's and DeepSeek R1's responses to urological problems: a comparative study.
Lu H, Zhang Y, Wang Z … +4 more , Zhao Y, Liu J, Qiu D, Zhang Y
BMC Urol · 2026 Jun · PMID 42323560 · Full text
BACKGROUND: Urology presents unique challenges for AI systems, requiring both extensive medical knowledge and advanced reasoning. While large language models (LLMs) like GPT-4 have shown promise in medical education and...
BACKGROUND: Urology presents unique challenges for AI systems, requiring both extensive medical knowledge and advanced reasoning. While large language models (LLMs) like GPT-4 have shown promise in medical education and decision support, their performance in urology remains underexplored. OBJECTIVE: To provide a time-stamped comparison of two representative large language models available at the time of evaluation, ChatGPT-4o and DeepSeek R1, in answering urology-related single-choice questions, and to evaluate their accuracy, stability, and response consistency across different response configurations. METHODS: A total of 809 single-choice questions from the Chinese National Qualification Examination for Attending Physicians in Urology were administered to ChatGPT-4o and DeepSeek R1. Each model was tested under three configurations: basic mode, deep-thinking mode, and web-enabled retrieval. Accuracy was calculated for each configuration, and statistical comparisons were performed using McNemar's test. Stability across reasoning modes was assessed by comparing performance variability. Additional analyses examined performance differences between short-answer and case-based clinical questions. RESULTS: ChatGPT-4o achieved accuracy rates of 78.12%, 73.79%, and 78.99% in basic, deep-thinking, and web-enabled retrieval modes, respectively. DeepSeek R1 outperformed ChatGPT-4o across all configurations, with accuracy rates of 83.19%, 81.46%, and 84.55%, respectively. All between-model differences were statistically significant (p < 0.001). DeepSeek R1 demonstrated greater internal stability across reasoning modes, whereas ChatGPT-4o showed notable variability. In subgroup analyses, DeepSeek R1 exhibited a more pronounced advantage in complex, case-based clinical questions. Both models performed consistently across urological disease categories, and findings were limited to the Chinese-language context in which the evaluation was conducted. CONCLUSION: DeepSeek R1 showed superior performance compared with ChatGPT-4o in both accuracy and stability when answering urology-related examination questions, particularly in complex case-based scenarios. These results suggest that optimized LLMs may have potential utility in urology education and examination-style question answering, especially within Chinese-language environments. However, these findings should not be interpreted as evidence of readiness for real-world clinical decision support, and further validation in clinically realistic settings is required.
Concurrent septic shock and massive renal hematoma following flexible ureteroscopy resulting in emergency nephrectomy: a case report.
Abdelhalim E, Galal M, Ibrahim A … +5 more , Elaty MA, Zeinelabden KM, Nabeeh H, Taha DE, Abdelbaky T
BMC Urol · 2026 Jun · PMID 42316127 · Full text
BACKGROUND: Flexible ureteroscopy (FURS) is widely considered a safe and effective modality for renal stone management. Severe infectious and hemorrhagic complications are uncommon but may be life-threatening. CASE-PRESE...
BACKGROUND: Flexible ureteroscopy (FURS) is widely considered a safe and effective modality for renal stone management. Severe infectious and hemorrhagic complications are uncommon but may be life-threatening. CASE-PRESENTATION: A 75-year-old man was referred to our tertiary center with hemodynamic instability following FURS performed at an outside institution for the treatment of a renal calculus. He presented with septic shock and acute anemia. Contrast-enhanced computed tomography revealed a massive perirenal hematoma compressing the renal parenchyma. Despite aggressive resuscitation, broad-spectrum antibiotics, and intensive care management, the patient's clinical condition deteriorated. Emergency nephrectomy was performed as a life-saving intervention. CONCLUSION: This case highlights the potential for rare combined septic and hemorrhagic complications following FURS. Early recognition and timely referral to specialized centers are critical to reducing mortality and optimizing patient outcomes.
Prognostic role of preoperative plasma fibrinogen-to-albumin ratio in urological carcinomas: a systematic review and meta-analysis.
Bao Z, An J, Li G … +1 more , Wang J
BMC Urol · 2026 Jun · PMID 42310688 · Full text
BACKGROUND: Growing evidence indicates that the pre-operative ratio of fibrinogen to albumin (FAR/AFR) can act as a prognostic predictor for different kinds of cancer. Although a previous meta-analysis briefly involved u...
BACKGROUND: Growing evidence indicates that the pre-operative ratio of fibrinogen to albumin (FAR/AFR) can act as a prognostic predictor for different kinds of cancer. Although a previous meta-analysis briefly involved urological malignancies, it only incorporated one study for bladder cancer (BC) and one for renal cell carcinoma (RCC) with limited data. To date, a comprehensive and systematic quantitative assessment of plasma FAR/AFR as a prognostic indicator in urological cancers remains lacking. OBJECTIVE: This meta-analysis intended to comprehensively investigate the prognostic significance of plasma FAR/AFR in individuals with urological malignancies. METHODS: A thorough search of the PubMed, Embase, and Web of Science databases was carried out up to March 2026, leading to the incorporation of 6 studies for this meta-analysis. The research computed hazard ratios (HRs) together with their 95% confidence intervals (CIs) to evaluate disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). RESULTS: The study included a total of 1,603 participants. Patients suffering from RCC and BC who showed an increase in pre-operation FAR or a decrease in pre-operation AFR had poorer overall survival (combined HR = 2.36, 95% CI = 1.92-2.91; p < 0.001), cancer-specific survival (combined HR = 2.27, 95% CI = 1.77-2.91; p = 0.003), and disease-free survival (combined HR = 2.32, 95% CI = 1.62-3.31; p < 0.001).Analysis based on cancer type showed that an increased pre-surgical FAR or a decreased pre-surgical AFR was associated with poorer overall survival in RCC) (combined HR = 3.19, 95% CI = 1.84-5.54, p < 0.001) and also in BC (combined HR = 2.25, 95% CI = 1.80-2.81, p < 0.001). CONCLUSIONS: Increased FAR or decreased AFR act as independent markers of unfavorable survival prognosis in patients with RCC and BC.
Quality, content structure, and reliability of prostatitis-related information on short-video platforms: a cross-platform analysis of TikTok and Bilibili.
Ding P, Luo Q, Cao L
BMC Urol · 2026 Jun · PMID 42310676 · Full text
BACKGROUND: Prostatitis, particularly chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), remains a common yet challenging condition in urological practice, largely due to its heterogeneous etiology, diagnostic c...
BACKGROUND: Prostatitis, particularly chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), remains a common yet challenging condition in urological practice, largely due to its heterogeneous etiology, diagnostic complexity, and high levels of patient anxiety. Increasingly, patients seek information about prostatitis from short-video platforms; however, the quality and clinical relevance of such content remain unclear. METHODS: A cross-sectional content analysis was conducted to evaluate prostatitis-related videos on TikTok and Bilibili. Video characteristics, engagement metrics, uploader type, and content themes were extracted. Information quality and reliability were assessed using the Global Quality Scale (GQS) and the modified DISCERN (mDISCERN) instrument, while content completeness was evaluated using a six-domain clinical information framework. Comparisons were performed across platforms and uploader categories, and correlations between engagement metrics and quality indicators were analyzed. RESULTS: A total of 223 videos were included. Overall information quality and reliability were moderate. Content distribution was heavily skewed toward treatment-related information, whereas disease awareness, diagnostic principles, and preventive or long-term management content were markedly underrepresented. Videos uploaded by healthcare professionals demonstrated significantly higher quality, reliability, and content completeness than those from non-professional sources. TikTok videos achieved higher overall quality and reliability scores compared with Bilibili. Engagement metrics showed only weak correlations with information quality and reliability indicators. CONCLUSION: Prostatitis-related information on short-video platforms is characterized by moderate quality and substantial structural imbalance, with an overemphasis on treatment and insufficient coverage of diagnostic reasoning and long-term management. From a urological clinical perspective, incomplete or misleading online information may shape patient expectations and has the potential to complicate clinical communication and shared decision-making, particularly regarding diagnostic evaluation, antibiotic expectations, and long-term management. Greater involvement of urologists in structured digital patient education and the promotion of clinically accurate content are needed to mitigate misinformation and improve patient understanding.
Comparative efficacy of transcutaneous tibial nerve stimulation (TTNS) versus solifenacin in female patients with overactive bladder.
Yazdi MS, Nazary-Moghadam S, Soleimani B … +3 more , Ahmadi SP, Sadabadi F, Sheikhi Z
BMC Urol · 2026 Jun · PMID 42310597 · Full text
BACKGROUND: Overactive bladder (OAB) is commonly managed with antimuscarinic agents, although tolerability limits long-term adherence. Tibial nerve stimulation (TNS) has emerged as a non-pharmacologic alternative. This s...
BACKGROUND: Overactive bladder (OAB) is commonly managed with antimuscarinic agents, although tolerability limits long-term adherence. Tibial nerve stimulation (TNS) has emerged as a non-pharmacologic alternative. This study compared the efficacy and safety of TNS versus solifenacin in women with OAB. METHODS: In this randomized controlled clinical trial, 118 patients met OAB diagnostic criteria, who presented to Qaem Hospital (Mashhad, Iran, 2023). Participants were randomly assigned to receive 12 weeks of either TNS (two 30-minute sessions weekly) or oral solifenacin (5 mg daily). Primary outcomes included changes in OAB symptom severity, urinary incontinence, and quality of life scores, using validated questionnaires at baseline and week 12. Statistical analysis was conducted using SPSS version 22, with significance set at p < 0.05. RESULTS: Both treatments led to significant improvement in OAB symptoms, urinary incontinence severity, and quality of life (all p < 0.001). TNS produced slightly greater improvement in OAB symptom severity (p = 0.016) and significantly greater reduction in urinary incontinence severity (p = 0.015). Quality of life improved substantially in both groups (p < 0.001), with comparable post-treatment scores. Adverse effects occurred in 88.1% of solifenacin users, whereas no side effects were reported with TNS. CONCLUSION: TNS is an effective and well-tolerated treatment for OAB, offering superior improvement in urinary incontinence and a markedly better safety profile compared with solifenacin. TNS may represent a preferable non-pharmacologic alternative for patients who cannot tolerate or do not respond adequately to anticholinergic medications. Future studies with larger cohorts and extended follow-up durations would be beneficial to validate and expand upon our findings. TRIAL REGISTRATION: The study protocol was officially registered in the Iranian Registry of Clinical Trials under the identifier IRCT20190618043934N25 on 2024-05-13.
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