BMC Urology[JOURNAL]
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200 papers
Is BMP-7 a promising diagnostic and prognostic biomarker for pediatric obstructive uropathy?
Shirazi M, Hosseini SH, Salehi M … +1 more , Shirazi S
BMC Urol · 2026 May · PMID 42163193 · Full text
BACKGROUND: Obstructive uropathy remains a major contributor to pediatric chronic kidney disease. Reliable biomarkers that predict disease progression or recovery are still lacking. Bone morphogenetic protein-7 (BMP-7),...
BACKGROUND: Obstructive uropathy remains a major contributor to pediatric chronic kidney disease. Reliable biomarkers that predict disease progression or recovery are still lacking. Bone morphogenetic protein-7 (BMP-7), known for its anti-fibrotic and renoprotective properties, has been proposed as a promising biomarker in renal injury. This study aimed to assess serum and urinary BMP-7 levels in pediatric obstructive uropathy and to evaluate its potential diagnostic and prognostic significance. METHODS: This prospective observational study enrolled 200 pediatric patients with obstructive uropathy (including UPJO, UVJO, and PUV) and 200 healthy controls. Serum and urinary BMP-7 levels were measured before and three months after surgery using a human BMP-7 ELISA kit (Zellbio). Comparisons were made between groups and between pre- and postoperative measurements using appropriate statistical analyses. RESULTS: Urinary BMP-7 levels were marginally higher and serum BMP-7 levels slightly lower in patients than in controls; however, these differences were not statistically significant (P > 0.05). Postoperative evaluations revealed a minor decrease in urinary BMP-7 and a mild increase in serum BMP-7, but again without statistical significance. No significant variations were found among obstruction subtypes (UPJO, UVJO, PUV). CONCLUSION: While BMP-7 plays a recognized role in renal repair in experimental models, its clinical diagnostic and prognostic utility in pediatric obstructive uropathy appears limited. Future research incorporating additional biomarkers and longer follow-up may further elucidate BMP-7's potential in predicting renal recovery and fibrosis modulation.
Aquablation for dual burden disease - BPH and chronic prostatitis/chronic pelvic pain syndrome: a single-center prospective pilot study.
Ghanim AF, Moschovas MC, Injiac J … +4 more , Chiriboga A, Allegro S, Rivera T, McDonald M
BMC Urol · 2026 May · PMID 42157180 · Full text
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) accounts for approximately 90-95% of prostatitis cases and is defined by pelvic pain or discomfort persisting for at least three of the preceding six...
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) accounts for approximately 90-95% of prostatitis cases and is defined by pelvic pain or discomfort persisting for at least three of the preceding six months in the absence of identifiable infection. Despite its high prevalence, management remains challenging, and no standardized treatment approach has been established. In men with concomitant benign prostatic hyperplasia (BPH), bladder outlet obstruction may contribute to symptom persistence or severity. Aquablation, a robot-assisted, waterjet-based therapy used for the treatment of BPH, enables precise, heat-free prostatic tissue removal and may provide symptomatic benefit in this clinical setting. METHODS: We performed a prospective pilot study including 20 men aged 45 years or older with diagnoses of both BPH and CP/CPPS who reported clinically significant symptoms, defined as an NIH-CPSI score of 8 or greater at screening. All patients underwent Aquablation between July and December 2024 and were evaluated at 1, 3, and 6 months following the procedure. Primary outcome measures included changes in International Prostate Symptom Score (IPSS) and NIH-CPSI, with assessment across pain, urinary, and quality-of-life (QoL) domains. RESULTS: Significant improvements in both IPSS and NIH-CPSI scores were observed by 3 months postoperatively (p < .001), with further modest and sustained improvements noted at 6 months. The greatest symptom reductions were seen in pain and quality-of-life domains. No major adverse events occurred during the study period. CONCLUSIONS: Aquablation was associated with improvement in both lower urinary tract symptoms and CP/CPPS-related symptom measures in men with coexisting BPH and CP/CPPS. These preliminary findings support further investigation of Aquablation as a potential treatment option for selected patients with this challenging clinical overlap.
Culture-detected urinary bacteria 10-20 years after tension-free vaginal tape surgery and associations with incontinence, pelvic pain, and dissatisfaction: a cross-sectional study.
Volløyhaug I, Solhaug BR, Larssen KW … +4 more , Haugum K, Nyhus MØ, Svenningsen R, Afset JE
BMC Urol · 2026 May · PMID 42151963 · Full text
BACKGROUND: Some women have persistent incontinence or pain after tension-free vaginal tape (TVT) surgery. Our objective was to study any association between culture-detected bacteriuria and incontinence, complications a...
BACKGROUND: Some women have persistent incontinence or pain after tension-free vaginal tape (TVT) surgery. Our objective was to study any association between culture-detected bacteriuria and incontinence, complications and satisfaction 10-20 years after TVT. METHODS: Cross-sectional study in 2022 of 127 women operated with TVT between 2001-2012 at Trondheim University Hospital, Norway. Validated questionnaires assessed stress urinary incontinence (SUI), urgency urinary incontinence (UUI), pelvic pain and satisfaction. Urine collected by sterile catheterization was cultivated for two (chromogenic and blood agar) and five days (blood, fastidious and chocolate agar). Symptoms and demographics were compared between women with and without significant bacterial growth, defined as ≥ 1.000 CFU/ml for this study, using chi-square test, Fishers exact test, t-test and logistic regression. Number of species detected after five days culture was tested in association to demographics and symptoms using Mann Whitney-U-test. RESULTS: 50/111 women (45.0%) had SUI, 54/122 (44.3%) had UUI, 95/116 (81.9%) were satisfied and 7/123 (5.7%) stated persistent pain. 16 (12.4%) had significant bacterial growth after two days of whom seven (44%) had a positive dipstick screening test (leukocytes or nitrite). After five days culture, 28 (22%) had significant bacterial growth. We found non-significantly higher odds for SUI (aOR 4.2, 95% CI 0.5-36.1) and UUI (aOR 2.1, 95% CI 0.3-13.7) in women with bacterial growth after two days. Bacterial growth after five days was associated with non-significantly increased risk of SUI (aOR 2.3, 95% CI 0.6-8.9) and UUI (aOR 3.4, 95% CI 0.9-13.6). Age was significantly associated with bacterial growth after two (aOR 1.2, 95% CI 1.02-1.3) and five days (aOR 1.1, 95% CI 1.04-1.2). The number of bacterial species after five days culture was higher in women with UUI, BMI > 75 percentile, in those dissatisfied or with persistent pain, than in women without these conditions (p < 0.01). CONCLUSIONS: Significant bacteriuria and larger variety of bacterial species were associated with incontinence, pain and dissatisfaction 10-20 years after TVT. The dipstick screening test had a sensitivity of only 44%. Extended urinary culture may be of value in optimizing treatment of urinary tract symptoms after TVT. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04912830).
Robot-assisted nephrectomy for retroperitoneal liposarcoma compressing the kidney: a case report with urological management perspective.
Shen H, Wang Y, Dong Z … +1 more , Wu J
BMC Urol · 2026 May · PMID 42151908 · Full text
BACKGROUND: Liposarcoma (LS) is the second most common histological subtype of soft tissue sarcoma, accounting for approximately 7% of all soft tissue sarcomas, among which retroperitoneal liposarcoma (RPLS) is not a rar...
BACKGROUND: Liposarcoma (LS) is the second most common histological subtype of soft tissue sarcoma, accounting for approximately 7% of all soft tissue sarcomas, among which retroperitoneal liposarcoma (RPLS) is not a rare clinical entity. While RPLS involving the kidney and requiring combined urological management is relatively uncommon with limited clinical reports, it is often asymptomatic in the early stage, with clinical symptoms appearing only when the tumor compresses adjacent organs. Surgical resection is the cornerstone of treatment. CASE PRESENTATION: A 54-year-old female was diagnosed with a well-differentiated giant retroperitoneal RPLS (250 mm × 92 mm) compressing the right kidney via contrast-enhanced MRI. After strict multidisciplinary evaluation in accordance with the 2024 NCCN Guidelines for Soft Tissue Sarcoma, preoperative core needle biopsy was not performed, and the retroperitoneal approach was selected for surgical intervention. On August 6, 2024, Da Vinci Xi Surgical System robot-assisted retroperitoneal tumor resection combined with right nephrectomy and retroperitoneal lymph node dissection was successfully completed via the retroperitoneal approach. Postoperative pathology and immunohistochemistry (MDM2 (+), S-100 (+), etc.) confirmed the diagnosis. The patient recovered uneventfully and was discharged on postoperative day 6 with individualized adjuvant targeted therapy. Follow-up CT scans at 3 months, 6 months, and 1 year postoperatively showed no tumor recurrence, and laboratory examinations such as serum creatinine were normal. This case preliminarily confirms the feasibility and safety of robot-assisted retroperitoneal approach for strictly selected giant RPLS (> 20 cm) confined to the retroperitoneal space, and provides a standardized urological management reference for similar cases. DISCUSSION: Most existing robot-assisted retroperitoneal liposarcoma (RPLS) surgeries are performed via the transabdominal approach, and the reported cases of retroperitoneal approach are limited to moderately sized tumors (diameter < 10 cm). This case demonstrates the feasibility and safety of robot-assisted retroperitoneal approach for giant RPLS (> 20 cm) strictly confined to the retroperitoneal space, expands the application scope of this approach, and provides a standardized urological management strategy for RPLS compressing the kidney for clinical reference.
A dynamic nomogram and risk classification for predicting prognosis in renal cell carcinoma with venous tumor thrombus.
Zhou Z, Ge L, Zhang F … +5 more , Deng S, Zhang H, Wang G, Lu M, Zhang S
BMC Urol · 2026 May · PMID 42151905 · Full text
BACKGROUND: To establish an effective dynamic nomogram and a novel risk classification system to predict overall survival (OS) for Renal Cell Carcinoma with venous tumor thrombus (RCC-VTT). METHODS: 318 patients were enr...
BACKGROUND: To establish an effective dynamic nomogram and a novel risk classification system to predict overall survival (OS) for Renal Cell Carcinoma with venous tumor thrombus (RCC-VTT). METHODS: 318 patients were enrolled and randomly divided into a training set and a validation set in a 7:3 ratio. LASSO regression analysis and multivariate Cox regression analysis were employed to identify significant prognostic factors. Based on these factors, a nomogram model was developed and evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analyses (DCA). Survival differences were assessed using Kaplan-Meier curves and the log-rank test. RESULTS: Eight survival predictors were identified: Mayo Clinic Stage, Histology, N Stage, M Stage, Renal Sinus Invasion, Sarcomatoid Feature, Hemoglobin, and Estimated Glomerular Filtration Rate. The C-indexes for the training and validation sets were 0.77 (95% CI: 0.72-0.82) and 0.75 (95% CI: 0.68-0.82), respectively. The AUCs for the training and validation sets were 0.869 (95% CI: 0.805-0.933) and 0.854 (95% CI: 0.770-0.937) for the 5-yr predictions, respectively. DCA further confirmed the clinical utility of the model. Additionally, the nomogram-based classification system stratified patients into distinct risk subgroups for OS (P < 0.0001). CONCLUSIONS: We developed a dynamic nomogram and novel risk classification system for RCC-VTT. This tool has the potential to personalize treatment strategies.
Efficacy of ventral onlay autologous tunica vaginalis graft in bulbar urethroplasty: an 11-year experience.
Yalçın K, Kölükçü E
BMC Urol · 2026 May · PMID 42143265 · Full text
BACKGROUND: Urethral stricture disease in men has historically been one of the most challenging urological problems. The treatment of complex urethral strictures, in particular, poses a major challenge due to urethral sc...
BACKGROUND: Urethral stricture disease in men has historically been one of the most challenging urological problems. The treatment of complex urethral strictures, in particular, poses a major challenge due to urethral scarring and fibrosis of the surrounding corpus spongiosum. Although various tissue types have been proposed for surgical reconstruction, the optimal graft material remains a subject of ongoing debate. In this study, we aimed to analyze the efficacy of using a ventral onlay autologous tunica vaginalis graft (TVOG) in bulbar urethroplasty. METHODS: Data from 43 patients diagnosed with bulbar urethral stricture and treated with the ventral onlay TVOG technique at our clinic between 2011 and 2022 were retrospectively reviewed. Patient age, American Society of Anesthesiologists (ASA) score, stricture length, number of internal urethrotomies performed, operative time, etiological factors, body mass index (BMI), length of hospital stay, time-dependent uroflowmetry Qmax values, and postoperative complications were recorded. Criteria for success were defined as patient satisfaction, a Qmax value exceeding 16 mL/s, patent urethrogram findings, and the absence of any need for dilation or further instrumentation during the follow-up period. RESULTS: The overall success rate was 74,4%. Failure occurred in 6 cases due to severe wound infection. Recurrent urethral stricture was detected in 5 cases. Superficial surgical site infection or hematoma was observed in 6 cases. No diverticulum formation was observed in any patient. Successful voiding was achieved in a total of 33 cases, with uroflowmetry Qmax values measured at 17 mL/s or higher. Comparison of Qmax values demonstrated a statistically significant difference (p < 0.05). Furthermore, no patient reported scrotal pain or discomfort during the follow-up period. CONCLUSIONS: The outcomes of using ventral onlay TVOG in bulbar urethroplasty appear favorable. Based on the data obtained from our study, it can be concluded that TVOG may be considered an alternative method in this field.
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.
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.
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.
The effect of tranexamic acid in perioperative bleeding transfusion in radical cystectomy: a systematic review and meta-analysis.
Makabe PF, Cavalcante LFF, Yuamoto B … +7 more , Battistuta SM, Costa GR, Meloni LGG, Vilela FEG, Bueno ISF, de Carvalho Fernandes R, de Toledo LGM
BMC Urol · 2026 May · PMID 42098720 · Full text
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent with demonstrated benefits in various surgical procedures, including urological surgeries. However, its effect on radical cystectomy (RC) remains uncertain...
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent with demonstrated benefits in various surgical procedures, including urological surgeries. However, its effect on radical cystectomy (RC) remains uncertain, largely due to limited data from an earlier meta-analysis that combined RC with substantially different urological procedures, as well as conflicting results from two recently published meta-analyses specifically evaluating the impact of TXA on RC. METHODS: This systematic review and meta-analysis was registered in PROSPERO (CRD42024628394) and conducted following PRISMA and Cochrane guidelines. Randomized controlled trials (RCTs) and observational studies comparing TXA versus no TXA in patients undergoing RC. Primary endpoints included perioperative blood transfusion (PBT) and venous thromboembolism (VTE). Random-effects models with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment were used to calculate pooled risk ratios (RR) and 95% confidence intervals (CI). RESULTS: Three studies (one RCT and two propensity-score matched observational studies) involving 1,344 patients (673 TXA; 671 control) were included. The pooled analysis for PBT showed a non-significant reduction in risk (RR 0.69; 95% CI 0.25-1.86; p = 0.25; I2 = 81%). Similarly, the risk of VTE was not significantly different between groups, although a potential trend toward increased risk was noted (RR 1.60; 95% CI 0.80-3.17; p = 0.10; I2 = 0%). CONCLUSIONS: Current evidence is underpowered to confirm the efficacy or safety of TXA during radical cystectomy. While no significant benefit or harm was identified, the wide confidence intervals necessitate further large-scale randomized trials to provide definitive clinical guidance.
Correction: Development of machine learning prediction models for postoperative outcomes in adult male circumcision.
Shpaner L, Saitta G
BMC Urol · 2026 May · PMID 42092895 · Full text
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Clinical value of VI-RADS score in predicting repeat transurethral resection in primary bladder cancer: a prospective observational study.
Aghayev A, Durak HM, Hepşen E … +2 more , Dinç E, Karabacak OR
BMC Urol · 2026 May · PMID 42067878 · Full text
BACKGROUND: Repeat transurethral resection of bladder tumor (TURBT) is recommended in selected patients with newly diagnosed bladder cancer to improve staging accuracy and detect residual disease, but it also increases m...
BACKGROUND: Repeat transurethral resection of bladder tumor (TURBT) is recommended in selected patients with newly diagnosed bladder cancer to improve staging accuracy and detect residual disease, but it also increases morbidity and treatment burden. The Vesical Imaging-Reporting and Data System (VI-RADS) has shown high accuracy for predicting muscle invasion, whereas its role in identifying patients who undergo repeat TURBT remains unclear. This study evaluated the clinical value of VI-RADS for predicting repeat TURBT status in primary bladder cancer. METHODS: This single-center prospective observational study included 59 patients with newly diagnosed primary bladder tumors who underwent preoperative multiparametric magnetic resonance imaging and initial TURBT. VI-RADS scores were assigned by an experienced radiologist blinded to pathological findings. Associations between VI-RADS and clinicopathological variables were examined using Spearman's correlation analysis. Diagnostic performance for predicting repeat TURBT status was assessed by receiver operating characteristic analysis. Univariable and multivariable logistic regression models were used to identify independent predictors of undergoing repeat TURBT. RESULTS: Repeat TURBT was performed in 31 patients (52.5%). Higher VI-RADS categories were more frequently observed among patients who underwent repeat TURBT, whereas lower categories predominated in the single-TURBT group. Among patients undergoing repeat TURBT, residual malignancy was identified in 66.7% of VI-RADS 4 lesions and 88.9% of VI-RADS 5 lesions. VI-RADS correlated significantly with tumor grade, invasion depth, tumor size, and number of surgical procedures. ROC analysis showed modest discriminatory ability for predicting repeat TURBT status (AUC 0.635, 95% CI 0.491-0.778; p = 0.066). At a cutoff of VI-RADS ≥ 3, sensitivity was 70.4% and specificity was 59.4%. In multivariable analysis, only invasion depth at initial TURBT independently predicted repeat TURBT. CONCLUSIONS: VI-RADS was associated with pathological tumor severity and with repeat TURBT status, but it did not independently predict undergoing repeat TURBT. These findings support VI-RADS as an adjunctive preoperative tool rather than a stand-alone determinant for repeat resection decisions.
Urinary exosomal miRNA profiling reveals sensitive non-invasive detection of bladder cancer.
Singh G, Kumar A, Kumar L … +7 more , Mishra N, Bhattacharjee S, Yadav K, Singh Y, Kumar U, Trivedi S, Singh SK
BMC Urol · 2026 Apr · PMID 42057041 · Full text
BACKGROUND: Urinary microRNAs (miRNAs) hold substantial promise as non-invasive biomarker candidates due to their molecular stability and tumor-selective expression signatures. This study integrates the high-throughput u...
BACKGROUND: Urinary microRNAs (miRNAs) hold substantial promise as non-invasive biomarker candidates due to their molecular stability and tumor-selective expression signatures. This study integrates the high-throughput urinary miRNA landscape with clinical data to systematically identify robust, non-invasive biomarkers that facilitate the early diagnosis and better clinical management of urinary bladder cancer (UBC). METHODS: Urine-derived miRNA sequencing was performed on UBC patients and healthy controls to delineate the miRNA expression profile. Computational filtering further excluded precursor form of miRNA, prioritizing the mature miRNA. Quantitative RT-PCR targeting an independent, age-matched cohort (n = 48) corroborated with the diagnostic potential of candidate miRNAs, evaluated through receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses. RESULTS AND LIMITATIONS: Next-generation sequencing unveiled 865 annotated and 11 novel miRNAs, with UBC samples displaying greater miRNA diversity (708 known miRNAs) compared to relative controls (540). Among them, seven mature miRNAs were significantly dysregulated in UBC (p < 0.05), of which quantitative RT-PCR corroborated significant upregulation of miR-6724-5p, miR-1273 h-5p, miR-7704, miR-200-5p, and miR-10400-5p, with fold elevations of 1542.3, 1085.8, 1160.6, 2776.5, and 45.8, respectively (p < 0.01). Stage-stratified profiling underscored dynamic shifts in miRNA expression that correlated with tumor advancement. A three-miRNA panel (miR-6724-5p, miR-10400-5p, and miR-7704) exhibited superior diagnostic performance (AUC > 70%, sensitivity > 90%). However, this study was constrained to a single institute with a small sample size and a short follow-up period, which precluded the correlation between the identified biomarker miRNAs with cancer recurrence and patient survival. CONCLUSION: In this preliminary, single-centre study, mature urinary miRNAs demonstrated reproducible, stage-specific dysregulation in UBC. A combinatorial panel offered potential for a highly sensitive, specific, and non-invasive detection method. These findings propel further multicentre studies to validate the observed signatures, supporting their potential towards future clinical application.
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